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Arai O.,Liver Disease Treatment Center | Arai O.,Kurashiki Central Hospital | Ikeda H.,Liver Disease Treatment Center | Matsueda K.,Kurashiki Central Hospital | And 2 more authors.
Journal of Japanese Society of Gastroenterology | Year: 2012

We describe a case of autoimmune hepatitis diagnosed after acute hepatitis B. The patient was a 65-year-old man admitted because of markedly elevated transaminase level. Laboratory tests showed positive IgM-HBc antibody and a short prothorombin time. He was diagnosed as severe acute hepatitis B due to sexual transmission. He received lamivudine and steroid pulse therapy. Transaminase level increased again after steroid pulse therapy and liver atrophy progressed, so cyclosporine was induced. Liver biopsy was done because of prolonged liver function disorder. Biopsy specimens showed not only centrizonal inflammation but also interface hepatitis and bridging fibrosis, which were characteristic of autoimmune hepatitis. We diagnosed autoimmune hepatitis which became clinically evident after acute hepatitis B. Lamivudine was discontinued 7 months after diagnosis and he is now receiving 3mg prednisolone.


Arai O.,Hamamatsu South Hospital | Arai O.,Kurashiki Central Hospital | Ikeda H.,Liver Disease Treatment Center | Matsueda K.,Kurashiki Central Hospital | And 3 more authors.
Acta Hepatologica Japonica | Year: 2010

We describe a rare case of acute-onset-type autoimmune hepatitis concomitant with idiopathic thrombocytopenic purpura. The patient was a 63-year-old woman admitted because of elevated transaminase level and thrombocytopenia. Laboratory tests showed hepatitis A, B, C virus and Epstein-Barr virus and antinuclear antibody were all negative. As she had medication history, we considered drug induced hepatitis was most likely diagnosis. Liver biopsy specimens done because of prolonged disorder of liver function revealed infiltration of inflammatory cells around central vein. Liver biopsy under laparoscope was done owing to making a definite diagnosis. Biopsies specimens showed not only centrizonal inflammation but also interface hepatitis and fibrosis characteristic of autoimmune hepatitis. We diagnosed acute-onset autoimmune hepatitis and started medication of predonisolon and ursodeoxycolic acid. Accordingly, disorder of liver function and thrombocytopenia improved. © 2010 The Japan Society of Hepatology.


Nishiguchi S.,Hyogo College of Medicine | Sakai Y.,Hyogo College of Medicine | Kuboki M.,Liver Disease Treatment Center | Tsunematsu S.,Kitasato Institute Hospital | And 6 more authors.
Liver International | Year: 2014

Abstract: Background & Aims: Faldaprevir (BI 201335) is a potent once-daily (QD) NS3/4A protease inhibitor for the treatment of patients with genotype-1 (GT-1) hepatitis C virus (HCV). The aim of this study was to evaluate the safety, pharmacokinetics and efficacy of faldaprevir plus pegylated interferon alfa-2a (PegIFN) and ribavirin (RBV) in Japanese patients infected with chronic GT-1 HCV. Methods: Part 1 of this phase II study was a randomized, double-blind, placebo-controlled, dose-ascending study. Treatment-naïve patients received faldaprevir 120 or 240 mg QD, or placebo, plus PegIFN/RBV for 4 weeks, then PegIFN/RBV alone for 44 weeks. In Part 2 (open label), treatment-experienced patients received faldaprevir 240 mg QD plus PegIFN/RBV for 4 weeks, then PegIFN/RBV alone for 44 weeks. Efficacy was assessed using sustained virological response (SVR) 24 weeks after treatment completion. The pharmacokinetics, safety and tolerability of faldaprevir were also assessed. Results: SVR was achieved by 4/6 (67%) treatment-naïve patients treated with faldaprevir 120 mg QD, 5/6 (83%) patients treated with faldaprevir 240 mg QD and 2/4 (50%) patients who received placebo. Of the treatment-experienced patients, 3/6 (50%) achieved SVR. Faldaprevir was well tolerated. There was one serious adverse event, which was not considered to be treatment related. Rash and hyperbilirubinaemia were more frequently reported with faldaprevir than with placebo in treatment-naïve patients, but no cases were severe or serious and none led to discontinuation. Steady-state plasma concentrations of faldaprevir were reached within 7 days of QD dosing. Conclusions: Faldaprevir with PegIFN/RBV was efficacious and well tolerated, supporting further evaluation of this combination in Japanese patients. © 2013 John Wiley & Sons A/S.


PubMed | Liver Disease Treatment Center
Type: Case Reports | Journal: Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology | Year: 2012

We describe a case of autoimmune hepatitis diagnosed after acute hepatitis B. The patient was a 65-year-old man admitted because of markedly elevated transaminase level. Laboratory tests showed positive IgM-HBc antibody and a short prothorombin time. He was diagnosed as severe acute hepatitis B due to sexual transmission. He received lamivudine and steroid pulse therapy. Transaminase level increased again after steroid pulse therapy and liver atrophy progressed, so cyclosporine was induced. Liver biopsy was done because of prolonged liver function disorder. Biopsy specimens showed not only centrizonal inflammation but also interface hepatitis and bridging fibrosis, which were characteristic of autoimmune hepatitis. We diagnosed autoimmune hepatitis which became clinically evident after acute hepatitis B. Lamivudine was discontinued 7 months after diagnosis and he is now receiving 3mg prednisolone.

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