Spontaneous Cirrhosis Regression in an IFN-beta-induced AIH-like Syndrome Following Drug Withdrawal: Art of Facts or Artifacts?

  • Maria Kalafateli Department of Gastroenterology, University Hospital of Patras
  • Christos Triantos Department of Gastroenterology, University Hospital of Patras
  • Athanasios Tsamandas Department of Pathology, University Hospital of Patras
  • George N Dalekos Department of Medicine and Research Laboratory of Internal Medicine, School of Medicine, University of Thessaly, Larissa

Keywords

Autoimmune hepatitis, cirrhosis, drug-induced liver injury, interferon-beta, multiple sclerosis.

Abstract

Autoimmune hepatitis (AIH) is a disease of unknown aetiology with drug-induced AIH being the most complex and not fully understood type. We present the case of a 57-year-old female patient with acute icteric hepatitis after interferon-beta-1b (IFNβ-1b) administration for multiple sclerosis (MS). Based on liver autoimmune serology, histology and appropriate exclusion of other liver diseases, a diagnosis of AIH-related cirrhosis was established. Following discontinuation of IFNβ-1b, a complete resolution of biochemical activity indices was observed and the patient remained untreated on her own decision. However, 3 years later, after a course of intravenous methylprednisolone for MS, a new acute transaminase flare was recorded which subsided again spontaneously after 3 weeks. Liver biopsy and elastography showed significant fibrosis regression (F2 fibrosis). To our knowledge, this is the first report showing spontaneous cirrhosis regression in an IFNβ-1b-induced AIH-like syndrome following drug withdrawal, suggesting that cirrhosis might be reversible if the offending fibrogenic stimulus is withdrawn.

Author Biographies

George N Dalekos,
Department of Medicine and Research Laboratory of Internal Medicine, School of Medicine, University of Thessaly, Larissa Professor of Medicine, Head Department of Medicine and Research Laboratory of Internal Medicine

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  • Published: 2016-06-07

    Issue: Vol 3 No 4 (view)

    Section: Articles

    How to cite:
    Kalafateli, M., Triantos, C., Tsamandas, A., & Dalekos, G. (2016). Spontaneous Cirrhosis Regression in an IFN-beta-induced AIH-like Syndrome Following Drug Withdrawal: Art of Facts or Artifacts?. European Journal of Case Reports in Internal Medicine, 3(4). https://doi.org/https://doi.org/10.12890/2016_000396