Rodríguez-Diaz Y, Reyes-Rodriguez R, Dorta-Francisco M C, Aguilera I, Perera-Molinero A, Moneva-Arce E, Aviles-Ruiz J F
Servicios de Aparato Digestivo, Hospital Universitario N.S. de Candelaria, Islas Canarias, Sevilla, España.
Transplant Proc. 2006 Jun;38(5):1467-70. doi: 10.1016/j.transproceed.2006.03.071.
De novo autoimmune hepatitis (AIH) is a rare disorder first described in 1998. It appears in patients with liver transplants for non-AIH etiology. The few cases in the literature make it a little known entity due to mechanisms that are unclear. We present the case of a woman with a liver transplant whose graft developed de novo AIH. Diagnosed with primary biliary cirrhosis, the patient underwent liver transplantation for refractory pruritus. Sixteen months after transplantation, we detected alterations in the hepatic profile with hypertransaminasemia and elevated alkaline phosphatase, together with elevated antinuclear antibodies. IgG levels were normal. Histological findings indicated AIH. The patient responded rapidly to treatment with prednisolone and azathioprine. De novo AIH in patients transplanted for PBC may cause graft dysfunction. This report also analyzes the case with respect to the other four reported cases, discussing etiologic hypotheses.
新发自身免疫性肝炎（AIH）是一种罕见疾病，于1998年首次被描述。它出现在因非AIH病因接受肝移植的患者中。由于发病机制尚不清楚，文献中报道的病例较少，这使得它成为一个鲜为人知的疾病实体。我们报告一例肝移植女性患者，其移植肝发生了新发AIH。该患者被诊断为原发性胆汁性肝硬化，因顽固性瘙痒接受了肝移植。移植后16个月，我们检测到肝功能指标异常，伴有转氨酶升高和碱性磷酸酶升高，同时抗核抗体升高。免疫球蛋白G水平正常。组织学检查结果提示为AIH。患者对泼尼松龙和硫唑嘌呤治疗反应迅速。因原发性胆汁性肝硬化接受移植的患者发生新发AIH可能导致移植肝功能障碍。本报告还结合其他4例报告病例对该病例进行了分析，并讨论了病因假说。
