title: Overlap syndrome of autoimmune hepatitis and primary biliary cirrhosis triggered by fluvastatin.
abstract: Although statins are generally well-tolerated drugs, recent cases of autoimmune hepatitis (AIH) associated with their use have been reported. A 59-year-old Japanese man reported with liver damage, which appeared one month after beginning treatment with fluvastatin and continued after discontinuation of the drug. Although drug-induced liver injury was possible, positive autoantibody tests (antinuclear antibodies >1/1280, anti-mitochondrial M2 antibodies 21 index value) also suggested autoimmune liver disease. Liver biopsy findings were consistent with an overlap of autoimmune hepatitis and primary biliary cirrhosis. Treatment with prednisone and ursodeoxycholic acid led to a good response. In this patient, manifestation of AIH and primary biliary cirrhosis overlap syndrome was possibly triggered by statin use. Autoimmune liver disease should be considered as a possible diagnosis in patients with evidence of prolonged liver damage after discontinuation of statins.
authors.affiliation: Department of Gastroenterology, Mishuku Hospital, 5-33-12, Kamimeguro, Meguro-ku, Tokyo, 153-0051, Japan. s-nakayama@mishuku.gr.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nakayama
authors.forename: Naoya
authors.initials: N
authors.lastname: Murashima
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000974:Antibodies, Antinuclear / Q000097:blood; D000924:Anticholesteremic Agents / Q000009:adverse effects*; D001323:Autoantibodies / Q000097:blood; D003324:Coronary Artery Disease / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005229:Fatty Acids, Monounsaturated / Q000009:adverse effects*; D000077340:Fluvastatin; D019693:Hepatitis, Autoimmune / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007211:Indoles / Q000009:adverse effects*; D008105:Liver Cirrhosis, Biliary / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D008928:Mitochondria / Q000276:immunology; D011241:Prednisone / Q000627:therapeutic use; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D000974:Antibodies, Antinuclear; D000924:Anticholesteremic Agents; D001323:Autoantibodies; D005229:Fatty Acids, Monounsaturated; D007211:Indoles; D000077340:Fluvastatin; D014580:Ursodeoxycholic Acid; D011241:Prednisone