title: De novo autoimmune hepatitis following liver transplantation for primary biliary cirrhosis: an unusual cause of late grafts dysfunction.
abstract: De novo autoimmune hepatitis (AIH) is a rare disorder first described in 1998. It occurs in patients who underwent liver transplantation for a different etiology. We present the case of a 56-year-old woman who was diagnosed with primary biliary cirrhosis and had liver transplantation for refractory pruritis. Seven years after transplantation, she presented alterations in the hepatic profile with hypertransaminasemia, elevated alkaline phosphatase and gamma-glutamyl-transferase. Her liver functions test also showed elevated IgG levels. Serum autoantibodies were negative except for antimitochondrial antibodies. Histological findings indicated features of AIH without bile duct damage or loss. She had a pretreatment AIH score of 13 points and a post treatment score of 15 points according to the International AIH Group. The patient was treated effectively with prednisolone and her liver function and globulin levels rapidly returned to normal.
authors.affiliation: Department of Hepato-Gastro-Enterology, Mongi Slim Hospital, Tunis, Tunisia ; University of Tunis El Manar, Faculty of Medicine, Tunis, Tunisia.
authors.forename: Rym
authors.initials: R
authors.lastname: Ennaifer
authors.affiliation: Department of Hepato-Gastro-Enterology, Mongi Slim Hospital, Tunis, Tunisia ; University of Tunis El Manar, Faculty of Medicine, Tunis, Tunisia.
authors.forename: Hend
authors.initials: H
authors.lastname: Ayadi
authors.affiliation: Department of Hepato-Gastro-Enterology, Mongi Slim Hospital, Tunis, Tunisia ; University of Tunis El Manar, Faculty of Medicine, Tunis, Tunisia.
authors.forename: Haifa
authors.initials: H
authors.lastname: Romdhane
authors.affiliation: Department of Hepato-Gastro-Enterology, Mongi Slim Hospital, Tunis, Tunisia ; University of Tunis El Manar, Faculty of Medicine, Tunis, Tunisia.
authors.forename: Meriem
authors.initials: M
authors.lastname: Cheikh
authors.affiliation: University of Tunis El Manar, Faculty of Medicine, Tunis, Tunisia ; Departement of Surgery, Mongi Slim Hospital, Tunis, Tunisia.
authors.forename: Hafedh
authors.initials: H
authors.lastname: Mestiri
authors.affiliation: University of Tunis El Manar, Faculty of Medicine, Tunis, Tunisia ; Departement of Surgery, Mongi Slim Hospital, Tunis, Tunisia.
authors.forename: Taher
authors.initials: T
authors.lastname: Khalfallah
authors.affiliation: Department of Hepato-Gastro-Enterology, Mongi Slim Hospital, Tunis, Tunisia ; University of Tunis El Manar, Faculty of Medicine, Tunis, Tunisia.
authors.forename: Najet Bel
authors.initials: NB
authors.lastname: Hadj
mesh_terms: D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D019693:Hepatitis, Autoimmune / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000601:surgery*; D008111:Liver Function Tests; D016031:Liver Transplantation; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone
keywords: Primary biliary cirrhosis; de novo autoimmune hepatitis; liver transplantation