Surgery Today

, Volume 41, Issue 7, pp 1016–1019

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

  • Kazuki Takeishi
  • Ken Shirabe
  • Takeo Toshima
  • Toru Ikegami
  • Kazutoyo Morita
  • Takasuke Fukuhara
  • Takashi Motomura
  • Yohei Mano
  • Hideaki Uchiyama
  • Yuji Soejima
  • Akinobu Taketomi
  • Yoshihiko Maehara
Case Report

DOI: 10.1007/s00595-010-4392-z

Cite this article as:
Takeishi, K., Shirabe, K., Toshima, T. et al. Surg Today (2011) 41: 1016. doi:10.1007/s00595-010-4392-z

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.

Key words

Liver transplantation Autoimmune hepatitis Pegylated interferon-α 

Copyright information

© Springer 2011

Authors and Affiliations

  • Kazuki Takeishi
    • 1
  • Ken Shirabe
    • 1
  • Takeo Toshima
    • 1
  • Toru Ikegami
    • 1
  • Kazutoyo Morita
    • 1
  • Takasuke Fukuhara
    • 1
  • Takashi Motomura
    • 1
  • Yohei Mano
    • 1
  • Hideaki Uchiyama
    • 1
  • Yuji Soejima
    • 1
  • Akinobu Taketomi
    • 1
  • Yoshihiko Maehara
    • 1
  1. 1.Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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