{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:32:12Z","timestamp":1793147532051,"version":"4.5.0"},"reference-count":0,"publisher":"Kare Publishing","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatol Forum"],"abstract":"<jats:p>The presence of autoantibody positivity with an elevated ferritin level and high transferrin saturation can create a diagnostic dilemma. This report describes the challenging case of 38-year-old male patient who presented with new-onset diabetes, malaise, weight loss, dark-yellow skin discoloration, and splenomegaly. Initial laboratory tests revealed thrombocytopenia, leucopenia, an elevated unconjugated bilirubin level, and mildly elevated liver enzymes in a cholestatic pattern. Antinuclear antibody and anti-smooth muscle antibody findings were positive with titers of 1\/160 and 1\/320, respectively, along with hypergammaglobulinemia. The transferrin saturation value was 92% and the ferritin level was 498 \u00b5g\/L. HFE gene mutation analysis revealed a C282Y heterozygote mutation, which is not diagnostic, but supported a diagnosis of hereditary hemochromatosis (HH). A liver biopsy is the most accurate way to differentiate autoimmune hepatitis from HH, and confirmed a diagnosis of HH. This case highlights the importance of paying close attention to all findings to avoid misdiagnosis and treatment which might result in dangerous outcomes. Additionally, in spite of a genetic test, a liver biopsy has great value as an important tool to determine an accurate diagnosis in patients with iron overload, especially in patients with concomitant autoantibody positivity.<\/jats:p>","DOI":"10.14744\/hf.2021.2021.0013","type":"journal-article","created":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T08:36:54Z","timestamp":1619426214000},"page":"76-79","source":"Crossref","is-referenced-by-count":0,"title":["In the presence of autoantibodies and iron overload, do not judge a book by its cover: A case report"],"prefix":"10.14744","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3368-3464","authenticated-orcid":false,"given":"Nur","family":"Yazdal\u0131 Koylu","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4462-6393","authenticated-orcid":false,"given":"Bahadir","family":"Koylu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7637-8745","authenticated-orcid":false,"given":"Cenk","family":"Sokmensuer","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0901-9192","authenticated-orcid":false,"given":"Yasemin","family":"Balaban","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5966","published-online":{"date-parts":[[2021]]},"container-title":["Hepatology Forum"],"original-title":[],"link":[{"URL":"https:\/\/file.paplino.com\/hepatologyforum\/pdfs\/1621865663-en.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/hepatologyforum.org\/storage\/upload\/pdfs\/1621865663-en.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T23:34:13Z","timestamp":1793144053000},"score":1,"resource":{"primary":{"URL":"https:\/\/hepatologyforum.org\/articles\/HF-18808"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.14744\/hf.2021.2021.0013","relation":{},"ISSN":["1307-5888","2757-7392"],"issn-type":[{"value":"1307-5888","type":"print"},{"value":"2757-7392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021]]}}}