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Takahashi A, Kanno Y, Takahashi Y, Sakamoto N, Monoe K, Saito H, Abe K, Yokokawa J, Irisawa A, Ohira H. Development of autoimmune hepatitis type 1 after pulsed methylprednisolone therapy for multiple sclerosis: A case report. World J Gastroenterol 2008; 14(35): 5474-5477 [PMID: 18803363 DOI: 10.3748/wjg.14.5474]
Atsushi Takahashi, Yukiko Kanno, Yuta Takahashi, Natsumi Sakamoto, Kyoko Monoe, Hironobu Saito, Kazumichi Abe, Junko Yokokawa, Atsushi Irisawa, Hiromasa Ohira, Department of Internal Medicine II, Fukushima Medical University School of Medicine, Fukushima, Japan
Author contributions: Takahashi A treated the patient and wrote the manuscript; Kanno Y, Takahashi Y, Sakamoto N, Monoe K, Saito H, Abe K and Yokokawa J treated the patient; Ohira H and Irisawa A revised the manuscript; Ohira H approved the final manuscripts.
Correspondence to: Atsushi Takahashi, Department of Internal Medicine II, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan. junior@fmu.ac.jp
Telephone: +81-24-547-1202 Fax: +81-24-547-2055
Received: July 14, 2008 Revised: August 26, 2008 Accepted: September 3, 2008 Published online: September 21, 2008
Abstract
A 43-year-old woman with multiple sclerosis (MS) was treated with pulsed methylprednisolone and interferon β at a hospital. Four weeks after initiating treatment, liver dysfunction occurred and she was referred and admitted to our hospital. Clinical and laboratory findings were consistent with and fulfilled the criteria for drug-induced hepatitis, but not for autoimmune hepatitis (AIH). She was successfully treated with corticosteroids. As ataxia developed after 1 year, she was treated with pulsed methylprednisolone for 3 d, then readmitted to our hospital when liver dysfunction occurred. Clinical and laboratory findings led to the diagnosis of AIH. To the best of our knowledge, this is the second case of AIH developed after pulsed methylprednisolone for MS.