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De novo autoimmune hepatitis associated with PTH(1-34) and PTH(1-84) administration for severe osteoporosis in a liver transplant patient.

TitleDe novo autoimmune hepatitis associated with PTH(1-34) and PTH(1-84) administration for severe osteoporosis in a liver transplant patient.
Publication TypeJournal Article
Year of Publication2012
AuthorsAnagnostis, P., Efstathiadou Z. A., Akriviadis E., Hytiroglou P., & Kita M.
JournalOsteoporos Int
Volume23
Issue9
Pagination2387-91
Date Published2012 Sep
ISSN1433-2965
KeywordsBiological Markers, Female, Glucocorticoids, Hepatitis, Autoimmune, Humans, Liver Cirrhosis, Biliary, Liver Transplantation, Methylprednisolone, Middle Aged, Osteoporosis, Postmenopausal, Parathyroid Hormone, Postoperative Complications
Abstract

De novo autoimmune hepatitis (AIH) is a rare graft dysfunction occurring in patients having undergone liver transplantation (LT) for causes other than AIH. We describe for the first time a case of de novo AIH associated with the administration of parathyroid hormone 1-34 [PTH(1-34)] and PTH(1-84) for severe osteoporosis. A 61-year-old woman was referred to our metabolic bone clinic due to severe osteoporosis, 3 years after LT for primary biliary cirrhosis. Initial treatment with PTH(1-34) led to asymptomatic hypertransaminasemia (two-fold the upper limit of normal), which normalized after drug discontinuation. A new flare of transaminases (three-fold the upper limit of normal) along with elevated alkaline phosphatase was observed after administration of PTH(1-84), which did not resolve after PTH(1-84) withdrawal. Subsequently, after exclusion of common causes of liver enzyme elevation, a liver biopsy was performed. Histological findings showed de novo AIH, which responded rapidly to treatment with methylprednisolone.

DOI10.1007/s00198-011-1848-y
Alternate JournalOsteoporos Int
PubMed ID22120908

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