Liver and Transplantation Unit, Montpellier School of Medicine and IRB-INSERM-1183, Montpellier, France.
Liver Int. 2018 Jun;38(6):995-999. doi: 10.1111/liv.13737. Epub 2018 Mar 31.
Although very rare, pantoprazole can result in acute hepatitis. It has yet to be reported, however, that it can also cause chronic autoimmune hepatitis.
AIM, METHOD AND RESULTS: We report the case of a patient in whom pantoprazole administration for 2 months was followed by acute liver injury with severe jaundice and features of autoimmunity. A liver biopsy revealed acute hepatocellular lesions associated with cholestasis, acute cholangitis and polymorphous inflammatory infiltration suggestive of drug-induced liver injury. The jaundice disappeared following discontinuation of the pantoprazole. There was, however, chronic autoimmune liver injury, with the occurrence of extensive liver fibrosis within a few months. This led to the administration of immunosuppressive agents, which led to progressive and complete recovery associated with the disappearance of autoantibodies.
This observation further supports the notion that pantoprazole can induce acute hepatocellular hepatitis, and it strongly suggests that it may trigger acute cholangitis and autoimmune liver injury. This case also helps document that some drugs can induce chronic autoimmune hepatitis that can resolve with immunosuppressive treatment.
尽管非常罕见，但泮托拉唑可导致急性肝炎。然而，据报道，它也可引起慢性自身免疫性肝炎。
目的、方法和结果：我们报告了一例患者的病例，该患者在接受泮托拉唑治疗 2 个月后发生急性肝损伤，伴有严重黄疸和自身免疫特征。肝活检显示急性肝细胞病变伴有胆汁淤积、急性胆管炎和多形性炎症浸润，提示药物性肝损伤。停用泮托拉唑后黄疸消失。然而，存在慢性自身免疫性肝损伤，在数月内发生广泛的肝纤维化。这导致使用免疫抑制剂，这导致与自身抗体消失相关的进行性和完全恢复。
这一观察结果进一步支持了泮托拉唑可诱导急性肝细胞性肝炎的观点，并强烈提示其可能引发急性胆管炎和自身免疫性肝损伤。该病例还有助于证明某些药物可引起慢性自身免疫性肝炎，免疫抑制治疗可缓解。
