title: De novo autoimmune hepatitis associated with PTH(1-34) and PTH(1-84) administration for severe osteoporosis in a liver transplant patient.
abstract: De novo autoimmune hepatitis (AIH) is a rare graft dysfunction occurring in patients having undergone liver transplantation (LT) for causes other than AIH. We describe for the first time a case of de novo AIH associated with the administration of parathyroid hormone 1-34 [PTH(1-34)] and PTH(1-84) for severe osteoporosis. A 61-year-old woman was referred to our metabolic bone clinic due to severe osteoporosis, 3 years after LT for primary biliary cirrhosis. Initial treatment with PTH(1-34) led to asymptomatic hypertransaminasemia (two-fold the upper limit of normal), which normalized after drug discontinuation. A new flare of transaminases (three-fold the upper limit of normal) along with elevated alkaline phosphatase was observed after administration of PTH(1-84), which did not resolve after PTH(1-84) withdrawal. Subsequently, after exclusion of common causes of liver enzyme elevation, a liver biopsy was performed. Histological findings showed de novo AIH, which responded rapidly to treatment with methylprednisolone.
authors: Department of Endocrinology, Hippokration Hospital, 49 Konstantinoupoleos Str., Thessaloniki, Greece. anagnwstis.pan@yahoo.gr
authors: P
authors: P
authors: Anagnostis
authors: Z A
authors: ZA
authors: Efstathiadou
authors: E
authors: E
authors: Akriviadis
authors: P
authors: P
authors: Hytiroglou
authors: M
authors: M
authors: Kita
mesh_terms: D015415:Biomarkers / Q000097:blood; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D019693:Hepatitis, Autoimmune / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000601:surgery; D016031:Liver Transplantation; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D010281:Parathyroid Hormone / Q000009:adverse effects*; D011183:Postoperative Complications / Q000139:chemically induced*
chemical_list: D015415:Biomarkers; D005938:Glucocorticoids; D010281:Parathyroid Hormone; D008775:Methylprednisolone