Antibody to hepatitis B e positive hepatitis induced by withdrawal of steroid therapy for polymyositis: response to interferon-alpha and cyclosporin A.
A 57-year-old woman was admitted with symmetrical proximal muscle weakness, liver dysfunction, abnormal muscle enzymes, and she was an antibody to hepatitis B e (anti-HBe) positive hepatitis B virus (HBV) carrier. Biopsy of her left quadriceps femoris showed myositis, so prednisolone was started at 40 mg/day. However, her hepatic function deteriorated and liver biopsy after 4 months showed acute hepatitis with partial submassive necrosis. Treatment with interferon-alpha and cyclosporin A progressively reduced the transaminase and HBV-DNA levels. Early treatment with interferon-alpha plus cyclosporin A can control exacerbation of hepatitis B.
Department of Internal Medicine, Ozu City Hospital, Ehime.
K
K
Nakanishi
M
M
Ishikawa
M
M
Nakauchi
A
A
Sakurai
K
K
Doi
Y
Y
Taniguchi
D000410:Alanine Transaminase / Q000097:blood; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001219:Aspartate Aminotransferases / Q000097:blood; D016572:Cyclosporine / Q000008:administration & dosage; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006509:Hepatitis B / Q000209:etiology* / Q000628:therapy* / Q000821:virology; D006510:Hepatitis B Antibodies / Q000096:biosynthesis*; D006515:Hepatitis B virus / Q000302:isolation & purification; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage; D008099:Liver / Q000473:pathology; D017114:Liver Failure, Acute / Q000209:etiology / Q000628:therapy / Q000821:virology; D008875:Middle Aged; D009336:Necrosis; D017285:Polymyositis / Q000188:drug therapy*; D011239:Prednisolone / Q000008:administration & dosage*
D000893:Anti-Inflammatory Agents; D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D016898:Interferon-alpha; D016572:Cyclosporine; D011239:Prednisolone; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase