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Digestive Diseases and Sciences

, Volume 50, Issue 1, pp 201–206 | Cite as

Flare-up of Autoimmune Hepatitis After Delivery in a Patient with Primary Biliary Cirrhosis: Postpartum Overlap Syndrome of Primary Biliary Cirrhosis and Autoimmune Hepatitis

  • Kazuo Ohba
  • Katsuhisa Omagari
  • Chika Kusakari
  • Yoshiko Kadokawa
  • Kenji Hayashida
  • Fuminao Takeshima
  • Yohei Mizuta
  • Ikuo Murata
  • Yasuni Nakanuma
  • Shigeru Kohno
CASE REPORT

KEY WORDS:

primary biliary cirrhosis autoimmune hepatitis overlap syndrome delivery pregnancy postpartum 

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References

  1. 1.
    Kaplan MM: Primary biliary cirrhosis. N Engl J Med 335:1570–1580, 1996PubMedGoogle Scholar
  2. 2.
    Nakanuma Y, Ohta G: Quantitation of hepatic granulomas and epithelioid cells in primary biliary cirrhosis. Hepatology 3:423–427, 1983PubMedCrossRefGoogle Scholar
  3. 3.
    Nakanuma Y, Tsuneyama K, Sasaki M, et al. : Destruction of bile ducts in primary biliary cirrhosis. Baillieres Best Pract Res Clin Gastroenterol 14:549–570, 2000PubMedGoogle Scholar
  4. 4.
    Czaja AJ, Freese DK: American Association for the Study of Liver Disease. Diagnosis and treatment of autoimmune hepatitis. Hepatology 36:479–497, 2002Google Scholar
  5. 5.
    Lohse AW, Meyer Zum Buschenfelde KH, Frantz B, et al. : Characterization of the overlap syndrome of primary biliary cirrhosis (PBC) and autoimmune hepatitis: Evidence for it being a hepatitic form of PBC in genetically susceptible individuals. Hepatology 29:1078–1084, 1999PubMedGoogle Scholar
  6. 6.
    Czaja AJ: Frequency and nature of the variant syndromes of autoimmune liver disease. Hepatology 28:360–365, 1998PubMedGoogle Scholar
  7. 7.
    Chazouillères O, Wendum D, Serfaty L, et al. : Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome: Clinical features and response to therapy. Hepatology 28:296–301, 1998PubMedGoogle Scholar
  8. 8.
    Vogel A, Wedemeyer H, P Manns M, Strassburg CP: Autoimmune hepatitis and overlap syndromes. J Gastroenterol Hepatol 17:S389–S398, 2002PubMedGoogle Scholar
  9. 9.
    Colombato LA, Alvarez F, Cote J, et al. : Autoimmune cholangiopathy: The result of consecutive primary biliary cirrhosis and autoimmune hepatitis?. Gastroenterology 107:1839–1843, 1994PubMedGoogle Scholar
  10. 10.
    Ostensen M: Sex hormones and pregnancy in rheumatoid arthritis and systemic lupus erythematosus. Ann NY Acad Sci 876:131–143, 1999PubMedGoogle Scholar
  11. 11.
    Buchel E, Van Steenbergen W, Nevens F, et al. : Improvement of autoimmune hepatitis during pregnancy followed by flare-up after delivery. Am J Gastroenterol 97:3160–3165, 2002PubMedGoogle Scholar
  12. 12.
    Colle I, Hautekeete M: Remission of autoimmune hepatitis during pregnancy: A report of two cases. Liver 19:55–57, 1999PubMedGoogle Scholar
  13. 13.
    Malhotra B, Malhotra N, Deka D, Takkar D: Immunosuppressive effect of pregnancy on autoimmune hepatitis: A case report and review of literature. Eur J Obstet Gynecol Reprod Biol 101:91–92, 2002PubMedGoogle Scholar
  14. 14.
    Amino N, Mori H, Iwatani Y, et al. : High prevalence of transient post-partum thyrotoxicosis and hypothyroidism. N Engl J Med 306:849–852, 1982PubMedCrossRefGoogle Scholar
  15. 15.
    Iijima T, Tada H, Hidaka Y, et al. : Prediction of postpartum onset of rheumatoid arthritis. Ann Rheum Dis 57:460–463, 1998CrossRefPubMedGoogle Scholar
  16. 16.
    Izumi Y, Kaneko A, Oku K, et al. : Development of liver dysfunction after delivery is possibly due to postpartum autoimmune hepatitis. A report of three cases. J Intern Med 252:361–367, 2002Google Scholar
  17. 17.
    Izumi Y, Tanaka S, Hidaka Y, et al. : Relation between post-partum liver dysfunction and anti-cytochrome 2D6 antibodies. Am J Reprod Immunol 50:355–362, 2003PubMedGoogle Scholar
  18. 18.
    Scheuer PJ, Lefkowitch JH: Liver Biopsy Interpretation, 6th ed. London, W.B. Saunders, 2000Google Scholar
  19. 19.
    Alvarez F, Berg PA, Bianchi FB, et al. : International Autoimmune Hepatitis Group Report: Review of criteria for diagnosis of autoimmune hepatitis. J Hepatol 31:929–938, 1999CrossRefPubMedGoogle Scholar
  20. 20.
    Mitchison HC, Palmer JM, Bassendine MF, et al. : A controlled trial of prednisolone treatment in primary biliary cirrhosis. Three-year results. J Hepatol 15:336–344, 1992Google Scholar
  21. 21.
    Poupon RE, Poupon R, Balkau B: Ursodiol for the long-term treatment of primary biliary cirrhosis. The UDCA-PBC Study Group. N Engl J Med 330:1342–1347, 1994Google Scholar
  22. 22.
    Nakamura K, Yoneda M, Yokohama S, et al. : Efficacy of ursodeoxycholic acid in Japanese patients with type 1 autoimmune hepatitis. J Gastroenterol Hepatol 13:490–495, 1998PubMedGoogle Scholar
  23. 23.
    Joshi S, Cauch-Dudek K, Wanless IR, et al. : Primary biliary cirrhosis with additional features of autoimmune hepatitis: Response to therapy with ursodeoxycholic acid. Hepatology 35:409–413, 2002PubMedGoogle Scholar
  24. 24.
    Whitacre CC: Sex differences in autoimmune disease. Nat Immunol 2:777–780, 2001PubMedGoogle Scholar
  25. 25.
    Harada K, Van de Water J, Leung PS, et al. : In situ nucleic acid hybridization of cytokines in primary biliary cirrhosis: Predominance of the Th1 subset. Hepatology 25:791–796, 1997PubMedGoogle Scholar
  26. 26.
    Heneghan MA, Norris SM, O’Grady JG, Harrison PM, McFarlane IG: Management and outcome of pregnancy in autoimmune hepatitis. Gut 48:97–102, 2001PubMedGoogle Scholar
  27. 27.
    Nir A, Sorokin Y, Abramovici H, Theodor E: Pregnancy and primary biliary cirrhosis. Int J Gynaecol Obstet 28:279–282, 1989PubMedGoogle Scholar
  28. 28.
    Wong KK, Goh KL: Pregnancy in primary biliary cirrhosis. Eur J Obstet Gynecol Reprod Biol 45:149–151, 1992PubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • Kazuo Ohba
    • 1
  • Katsuhisa Omagari
    • 1
  • Chika Kusakari
    • 1
  • Yoshiko Kadokawa
    • 1
  • Kenji Hayashida
    • 1
  • Fuminao Takeshima
    • 1
  • Yohei Mizuta
    • 1
  • Ikuo Murata
    • 2
  • Yasuni Nakanuma
    • 3
  • Shigeru Kohno
    • 1
  1. 1.Second Department of Internal MedicineNagasaki University School of MedicineNagasakiJapan
  2. 2.Division of PharmacotherapeuticsNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
  3. 3.Second Department of PathologyKanazawa University School of MedicineKanazawaJapan

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