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Post‐liver transplantation de novo hepatitis with overlap features
Author(s) -
Keaveny Andrew P.,
Gordon Fredric D.,
Khettry Urmila
Publication year - 2005
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.2005.01886.x
Subject(s) - autoimmune hepatitis , overlap syndrome , medicine , primary biliary cirrhosis , prednisone , liver transplantation , ursodeoxycholic acid , liver biopsy , immunology , tacrolimus , hepatitis , liver disease , gastroenterology , transplantation , biopsy , disease
The development of de novo autoimmune liver disease after liver transplantation (LT) has been described in both children and adults. Reported herein is a case that is best characterized as post‐LT de novo hepatitis with features of autoimmune hepatitis (AIH)–primary biliary cirrhosis (PBC) overlap. A 56‐year‐old man underwent LT for decompensated liver disease secondary to non‐alcoholic steatohepatitis. His liver function tests became markedly abnormal 8 months after LT. Sequential liver transplant biopsy findings were confusing and shared findings seen with both AIH and PBC. Although standard autoimmune serological tests were negative, a dramatic biochemical response was observed to a regimen consisting of prednisone, mycophenolate mofetil, and ursodeoxycholic acid added to maintainance tacrolimus. The donor was histocompatibility leukocyte antigen, DR4, positive, a haplotype associated with the development of AIH–PBC overlap syndrome. In conclusion the authors believe that this may be a case of post‐LT de novo overlap syndrome of AIH‐PBC, a novel ‘autoimmune‐type’ response.