Fulminant hepatic failure in a case of autoimmune hepatitis in hepatitis C during peg-interferon-alpha 2b plus ribavirin treatment.
A 27-year-old Caucasian female with hepatitis C virus (HCV) infection treated with interferon (IFN) who developed severe autoimmune hepatitis (AIH) is described. The infecting viral strain was of genotype Ib and the pre-treatment HCV viral load was at a high level. The patient was treated with pegylated IFN-alpha 2b and ribavirin, and her HCV-RNA became negative at wk 12, but after that she developed fulminant hepatic failure. The patient recovered after steroid pulse therapy consisting of methylprednisolone 1000 mg/d for three days which was administered twice. A needle liver biopsy revealed the typical pathological findings of AIH.
Kogure
Takayuki
T
Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba, Sendai City 980-8574, Japan.
Ueno
Yoshiyuki
Y
Fukushima
Koji
K
Nagasaki
Futoshi
F
Inoue
Jun
J
Kakazu
Eiji
E
Matsuda
Yasunori
Y
Kido
Osamu
O
Nakagome
Yu
Y
Kimura
Osamu
O
Obara
Noriyuki
N
Wakui
Yuta
Y
Iwasaki
Takao
T
Shimosegawa
Tooru
T
D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001706:Biopsy; D004359:Drug Therapy, Combination; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy; D019693:Hepatitis, Autoimmune / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008099:Liver / Q000473:pathology; D017114:Liver Failure, Acute / Q000139:chemically induced* / Q000175:diagnosis; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b
Gastroenterology. 1995 Jun;108(6):1770-7
7768382
World J Gastroenterol. 2006 Jul 14;12 (26):4253-5
16830387
Hepatology. 2004 Apr;39(4):1147-71
15057920
Gastroenterology. 2001 May;120(6):1485-501
11313320
Gastroenterology. 1992 Apr;102(4 Pt 1):1406-8
1551549
Eur J Immunol. 1993 May;23(5):1105-11
7682958
Hepatology. 1995 Nov;22(5):1374-8
7590650
Am J Hematol. 2003 Mar;72(3):170-6
12605388
Transplantation. 2006 Feb 15;81(3):488-90
16477242
Autoimmunity. 2003 Dec;36(8):519-23
14984029
Ann Intern Med. 1992 Jan 1;116(1):51-3
1727095
World J Gastroenterol. 2004 Jan;10(1):12-6
14695760
Liver Transpl. 2006 May;12 (5):827-30
16628699
J Exp Med. 1999 Jul 19;190(2):169-76
10432280