title: De novo autoimmune hepatitis subsequent to switching from type 2b to type 2a alpha-pegylated interferon treatment for recurrent hepatitis C after liver transplantation: report of a case.
abstract: Interferon (IFN), which is the only possible agent for recurrent hepatitis C after liver transplantation, may cause serious immune-related disorders. We report a case of de novo autoimmune hepatitis (AIH), which developed subsequent to switching from 2b pegylated interferon-α (peg-IFN) to 2a peg-IFN after living donor liver transplantation (LDLT). A 51-year-old man with hepatitis C-associated liver cirrhosis underwent LDLT. About 13 months after the initiation of antiviral therapy, in the form of type 2b peg-IFN with ribavirin, a negative serum hepatitis C virus (HCV)-RNA titer was confirmed. Thereafter, the 2b peg-IFN was switched to 2a peg-IFN, 3 months after which severe liver dysfunction developed, despite a constantly negative HCV-RNA. Liver biopsy showed portal and periportal inflammatory infiltrates including numerous plasma cells, indicating AIH. He was treated with steroid pulse treatment, followed by high-level immunosuppression maintenance, but eventually died of Pneumocystis pneumonitis 4 months after the diagnosis of de novo AIH.
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors: Kazuki
authors: K
authors: Takeishi
authors: Ken
authors: K
authors: Shirabe
authors: Takeo
authors: T
authors: Toshima
authors: Toru
authors: T
authors: Ikegami
authors: Kazutoyo
authors: K
authors: Morita
authors: Takasuke
authors: T
authors: Fukuhara
authors: Takashi
authors: T
authors: Motomura
authors: Yohei
authors: Y
authors: Mano
authors: Hideaki
authors: H
authors: Uchiyama
authors: Yuji
authors: Y
authors: Soejima
authors: Akinobu
authors: A
authors: Taketomi
authors: Yoshihiko
authors: Y
authors: Maehara
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D001706:Biopsy; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000209:etiology; D019693:Hepatitis, Autoimmune / Q000209:etiology* / Q000276:immunology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a