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Autoimmune Hepatitis Triggered by Treatment With Pegylated Interferon α-2a and Ribavirin for Chronic Hepatitis C.

Rathi C, Pipaliya N, Choksi D, Parikh P, Ingle M, Sawant P - ACG Case Rep J (2015)

Bottom Line: Hepatitis flare is rarely observed during treatment with pegylated interferon alpha for hepatitis C virus (HCV) infection.Pegylated interferon was discontinued; a few weeks later, his aminotransferases and immunoglobulin levels increased significantly.Antibody to cytosolic liver antigen-1 was positive, and liver biopsy revealed lymphoplasmacytic infiltrate with intense interface hepatitis, consistent with autoimmune hepatitis.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India.

ABSTRACT
Hepatitis flare is rarely observed during treatment with pegylated interferon alpha for hepatitis C virus (HCV) infection. A 49-year-old man receiving pegylated interferon α-2a for HCV infection had icterus and hyperbiliru-binemia in the 14th week of therapy, with HCV RNA undetectable after the 12th dose. Liver biopsy was suggestive of chronic hepatitis with cirrhosis without interface pattern. Pegylated interferon was discontinued; a few weeks later, his aminotransferases and immunoglobulin levels increased significantly. Antibody to cytosolic liver antigen-1 was positive, and liver biopsy revealed lymphoplasmacytic infiltrate with intense interface hepatitis, consistent with autoimmune hepatitis.

No MeSH data available.


Related in: MedlinePlus

Initial liver biopsy with H&E stain showing ongoing chronic hepatitis with fibrous septa containing moderate inflammation. Inflammatory cells consist of mainly lymphocytes and few plasma cells.
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Figure 1: Initial liver biopsy with H&E stain showing ongoing chronic hepatitis with fibrous septa containing moderate inflammation. Inflammatory cells consist of mainly lymphocytes and few plasma cells.

Mentions: Hepatitis B surface antigen, hepatitis B virus (HBV) DNA, anti-nuclear antibody, anti-mitochondrial antibody, anti-liver kidney microsome 1 antibody, anti-double stranded DNA antibody, anti-hepatitis A virus IgM antibody, and anti-hepatitis E virus IgM antibody were negative. Thyroid stimulating hormone was normal. HCV RNA was undetectable after termination of therapy until 6 months of follow-up. Liver biopsy was suggestive of chronic hepatitis with cirrhosis, without any evidence of steatosis, significant interface, or pseudoacinar pattern (Figure 1).


Autoimmune Hepatitis Triggered by Treatment With Pegylated Interferon α-2a and Ribavirin for Chronic Hepatitis C.

Rathi C, Pipaliya N, Choksi D, Parikh P, Ingle M, Sawant P - ACG Case Rep J (2015)

Initial liver biopsy with H&E stain showing ongoing chronic hepatitis with fibrous septa containing moderate inflammation. Inflammatory cells consist of mainly lymphocytes and few plasma cells.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508956&req=5

Figure 1: Initial liver biopsy with H&E stain showing ongoing chronic hepatitis with fibrous septa containing moderate inflammation. Inflammatory cells consist of mainly lymphocytes and few plasma cells.
Mentions: Hepatitis B surface antigen, hepatitis B virus (HBV) DNA, anti-nuclear antibody, anti-mitochondrial antibody, anti-liver kidney microsome 1 antibody, anti-double stranded DNA antibody, anti-hepatitis A virus IgM antibody, and anti-hepatitis E virus IgM antibody were negative. Thyroid stimulating hormone was normal. HCV RNA was undetectable after termination of therapy until 6 months of follow-up. Liver biopsy was suggestive of chronic hepatitis with cirrhosis, without any evidence of steatosis, significant interface, or pseudoacinar pattern (Figure 1).

Bottom Line: Hepatitis flare is rarely observed during treatment with pegylated interferon alpha for hepatitis C virus (HCV) infection.Pegylated interferon was discontinued; a few weeks later, his aminotransferases and immunoglobulin levels increased significantly.Antibody to cytosolic liver antigen-1 was positive, and liver biopsy revealed lymphoplasmacytic infiltrate with intense interface hepatitis, consistent with autoimmune hepatitis.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India.

ABSTRACT
Hepatitis flare is rarely observed during treatment with pegylated interferon alpha for hepatitis C virus (HCV) infection. A 49-year-old man receiving pegylated interferon α-2a for HCV infection had icterus and hyperbiliru-binemia in the 14th week of therapy, with HCV RNA undetectable after the 12th dose. Liver biopsy was suggestive of chronic hepatitis with cirrhosis without interface pattern. Pegylated interferon was discontinued; a few weeks later, his aminotransferases and immunoglobulin levels increased significantly. Antibody to cytosolic liver antigen-1 was positive, and liver biopsy revealed lymphoplasmacytic infiltrate with intense interface hepatitis, consistent with autoimmune hepatitis.

No MeSH data available.


Related in: MedlinePlus