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 (IFN?-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 IFN?-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 IFN?-1b-induced AIH-like syndrome following drug withdrawal, suggesting that cirrhosis might be reversible if the offending fibrogenic stimulus is withdrawn.

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    Published: 2016-06-07
    Issue: Vol. 3 No. 4 (view)

    How to cite:
    1.
    Kalafateli M, Triantos C, Tsamandas A, Dalekos GN. Spontaneous Cirrhosis Regression in an IFN-beta-induced AIH-like Syndrome Following Drug Withdrawal: Art of Facts or Artifacts?. EJCRIM 2016;3 doi:10.12890/2016_000396.