Post-liver transplantation de novo hepatitis with overlap features

Andrew P. Keaveny, Fredric D. Gordon, Urmila Khettry

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)660-664
Number of pages5
JournalPathology International
Volume55
Issue number10
DOIs
StatePublished - Oct 1 2005

Keywords

  • Allograft
  • Autoimmune
  • Autoimmune hepatitis
  • Biliary
  • Hepatic
  • Liver
  • Primary biliary cirrhosis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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