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首页> 外文期刊>The Journal of pharmacy technology: jPT : official publication of the Association of Pharmacy Technicians >Autoimmune Hepatitis Induced by Interferon Beta Therapy in a Patient with Multiple Sclerosis: A Case Report
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Autoimmune Hepatitis Induced by Interferon Beta Therapy in a Patient with Multiple Sclerosis: A Case Report

机译：干扰素β治疗多发性硬化症患者引起的自身免疫性肝炎：病例报告。

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Objective: To report a case of a woman who had multiple sclerosis and developed autoimmune hepatitis (AIH) induced by interferon beta therapy.Case Summary: A 35-year-old woman with multiple sclerosis was being treated with interferon beta when she presented with fatigue and jaundice. Liver biochemistry testing revealed acute hepatitis (alanine and aspartate aminotransferase values >10 times the upper limit of normal) that was histologically consistent with AIH. Our patient had a score of 9 on the Roussel Uclaf Causality Assessment Method scale, indicating a high probability that hepatotoxicity in this case was related to interferon beta therapy. The patient had spontaneous clinical and biochemical improvement after stoppage of treatment. However, when she resumed interferon beta therapy, derangement of liver function reappeared, which again responded well to discontinuation of interferon.Discussion: Interferons can induce many autoimmune diseases due to their immunomodulatory effects. Autoimmune thyroid diseases and, to a lesser extent, skin and pulmonary involvement, are frequently reported during interferon alfa treatment for chronic hepatitis C. Several different forms of hepatotoxicity have also been described with interferon alfa and beta therapy, but few cases of AIH induced by interferon are reported in the literature. AIH has been described in association with interferon alfa therapy; however, this association with interferon beta therapy is extremely rare, and only a handful of cases have been described. Moreover, reports of previous cases were not rechallenged with the same medication, thereby failing to demonstrate firm evidence of causality. This is the first report of the disease reappearing upon drug rechallenge. In addition, we have shown that interferon-induced AIH can be suitably treated by drug withdrawal rather than by institution of steroid therapy.Conclusions: Practitioners need to be aware of the potential complication of AIH induced by interferon beta; this condition occurs independently of the typically benign enzyme elevations frequently reported with this drug.
机译：目的：报道一例患有多发性硬化症并由干扰素β疗法诱发的自身免疫性肝炎（AIH）的妇女。病例摘要：一名35岁多发性硬化症的妇女在出现疲劳时接受了β-干扰素的治疗。和黄疸。肝生化检查显示，急性肝炎（丙氨酸和天冬氨酸转氨酶值大于正常上限的10倍）在组织学上与AIH一致。我们的患者在Roussel Uclaf因果关系评估方法量表中的得分为9，表明这种情况下的肝毒性与β干扰素治疗相关的可能性很高。停药后患者自发的临床和生化改善。然而，当她恢复干扰素β治疗后，肝功能再次出现紊乱，再次对干扰素的停用反应良好。讨论：干扰素由于具有免疫调节作用，可诱发多种自身免疫性疾病。在慢性丙型肝炎的干扰素阿尔法治疗期间，经常报告自身免疫性甲状腺疾病，以及较小程度的皮肤和肺部受累。干扰素α和β治疗还描述了几种不同形式的肝毒性，但很少有由乙肝引起的AIH病例干扰素已有文献报道。已经描述了AIH与干扰素α疗法的结合。然而，这种与干扰素β疗法的联系非常少见，仅描述了少数病例。此外，以前的病例报告没有用相同的药物治疗，因此未能证明有因果关系。这是该药物再次攻击后该疾病再次出现的第一份报告。此外，我们已经表明，可以通过停药而不是通过类固醇疗法来适当治疗干扰素诱导的AIH。结论：从业者需要意识到干扰素β诱导的AIH的潜在并发症;这种情况的发生与该药物经常报道的典型的良性酶升高无关。

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