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Successful tacrolimus therapy for a severe recurrence of type 1 autoimmune hepatitis in a liver graft recipient
Author(s) -
Hurtova Monika,
DuclosVallée JeanCharles,
Johanet Catherine,
Emile JeanFrancçois,
RoqueAfonso AnneMarie,
Feray Cyrille,
Bismuth Henri,
Samuel Didier
Publication year - 2001
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2001.24638
Subject(s) - medicine , tacrolimus , autoimmune hepatitis , azathioprine , liver transplantation , liver function tests , liver biopsy , gastroenterology , liver function , hepatitis , transplantation , biopsy , disease
A 34‐year‐old woman underwent orthotopic liver transplantation (OLT) for decompensated type 1 autoimmune hepatitis (AIH). She was administered standard tripledrug immunosuppressive therapy (cyclosporine, steroids, and azathioprine). Ten years after OLT, she developed a recurrence of AIH, with emergence of serological markers of autoimmunity (high anti‐smooth muscle antibody [ASMA] titer, high serum gamma globulin level), abnormal liver function test results, and characteristic histological features on liver biopsy. Despite intensified steroid therapy, her clinical and liver function deteriorated. The onset of cutaneous alternariosis led to a steroid dose reduction and cyclosporine replacement by tacrolimus. Clear‐cut amelioration was observed, with an improvement in liver function test results and reduction in ASMA titer. One year after the recurrence of AIH, the patient has normal liver function and physical findings. Tacrolimus therefore may be effective in patients with severe recurrent autoimmune liver disease. Further studies are needed to assess tacrolimus therapy in patients who fail to respond to standard immunosuppressive therapy.