scholarly journals Pancolitis with Ischemic Injury as a Complication of Immunosuppressive Treatment in a Patient with Autoimmune Hepatitis: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
A. Dalbeni ◽  
E. Capoferro ◽  
L. Bernardoni ◽  
P. Capelli ◽  
A. Caliò ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Ischemic Colitis ◽  
Hepatitis A ◽  
Immunosuppressive Treatment ◽  
Ischemic Injury ◽  
Entire Colon ◽  
Drug Induced ◽  
First Case ◽  
Inflammatory Bowel ◽  
Massive Rectal Bleeding

Ischemic colitis is a serious drug-induced adverse event. There are only few cases of immunosuppression-associated ischemic colitis described in the literature, but none with a pancolitis-like manifestation. We report the case of a 72-year-old female patient who developed a pancolitis with ischemic injury on immunosuppressive treatment with steroids and azathioprine for autoimmune hepatitis. The patient presented with massive rectal bleeding. Colonoscopy confirmed the diagnosis of pancolitis. The results of histological examination indicated drug-induced ischemic colitis involving the entire colon. This is the first case of ischemic pancolitis mimicking an inflammatory bowel disease (IBD) in a patient with immunosuppressive therapy.

scholarly journals Listeria monocytogenesMeningitis in an Immunosuppressed Patient with Autoimmune Hepatitis and IgG4 Subclass Deficiency

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Shahin Gaini
Keyword(s):  
Listeria Monocytogenes ◽  
Autoimmune Hepatitis ◽  
Hepatitis A ◽  
Immunosuppressive Treatment ◽  
Caucasian Woman ◽  
Immunosuppressed Patient ◽  
First Case ◽  
Low Levels ◽  
Diagnostic Work ◽  
Work Up

A 51-year-old Caucasian woman withListeria monocytogenesmeningitis was treated and discharged after an uncomplicated course. Her medical history included immunosuppressive treatment with prednisolone and azathioprine for autoimmune hepatitis. A diagnostic work-up after the meningitis episode revealed that she had low levels of the IgG4 subclass. To our knowledge, this is the first case report describing a possible association between autoimmune hepatitis and the occurrence ofListeria monocytogenesmeningitis, describing a possible association betweenListeria monocytogenesmeningitis and deficiency of the IgG4 subclass and finally describing a possible association betweenListeria monocytogenesmeningitis and immunosuppressive therapy with prednisolone and azathioprine.

scholarly journals Menotrophin Induced Autoimmune Hepatitis

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Shurouq H. Alqrinawi ◽  
Nuralhuda Akbar ◽  
Hind AlFaddag ◽  
Shahrazad Akbar ◽  
Lujayn Akbar ◽  
...  
Keyword(s):  
Liver Injury ◽  
Autoimmune Hepatitis ◽  
Plasma Cells ◽  
Caucasian Woman ◽  
Drug Induced ◽  
Over The Counter ◽  
Drug Induced Liver Injury ◽  
First Case ◽  
Igg Level ◽  
New Onset

Menotrophin is a protein-based hormonal therapy. It is used as a fertility medication that is given as injection either subcutaneously or intramuscularly. Menotrophin has not been previously reported to cause drug-induced liver injury. Drug-induced liver injury (DILI) is commonly seen nowadays with the expansion of the drug industry. It is associated with prescribed medications, over the counter drugs, herbal and dietary supplements. We report the first case of Menotrophin-induced autoimmune hepatitis in a 26-year-old Caucasian woman who was diagnosed with primary infertility due to failure to conceive after five years of marriage. She had received several cycles of Menotrophin, then developed new onset jaundice and fatigue associated with increase in transaminases. She had normal baseline liver function and enzymes prior to receiving treatment with Menotrophin. Evaluation showed no evidence of viral hepatitis, metabolic, alcoholic or vascular causes of liver injury. Autoimmune screening was positive for antinuclear antibody (ANA) with titer of 1 : 640 fine speckled, immunoglobulin G (IgG) level was 1900 mg/dl. Antimitochondrial antibodies (AMA) and antismooth muscle antibodies were negative. Liver biopsy showed features of chronic hepatitis with interface hepatitis and prominence of plasma cells, which best reflects autoimmune hepatitis. Her liver enzymes and bilirubin completely normalized after discontinuation of further Menotrophin therapy and starting treatment with prednisolone and Azathioprine.

scholarly journals Clinical features and outcomes of patients with drug-induced autoimmune hepatitis: A retrospective cohort study

2014 ◽  
Vol 46 (12) ◽  
pp. 1116-1120 ◽  
Author(s):  
Anna Licata ◽  
Marcello Maida ◽  
Daniela Cabibi ◽  
Giuseppe Butera ◽  
Fabio S. Macaluso ◽  
...  
Keyword(s):  
Cohort Study ◽  
Autoimmune Hepatitis ◽  
Clinical Features ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hepatitis A ◽  
Drug Induced

scholarly journals PWE-284 Khat as a possible cause of drug induced autoimmune hepatitis; a case series

Gut ◽  
2012 ◽  
Vol 61 (Suppl 2) ◽  
pp. A413.2-A413
Author(s):  
S Riyaz ◽  
M Imran ◽  
M Karajeh
Keyword(s):  
Autoimmune Hepatitis ◽  
Hepatitis A ◽  
Case Series ◽  
Drug Induced ◽  
Possible Cause

scholarly journals A257 NEW ONSET ULCERATIVE COLITIS IN A PATIENT WITH KNOWN AUTOIMMUNE HEPATITIS TYPE 1

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 134-135
Author(s):  
M Hasan ◽  
Z Gallinger
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Autoimmune Hepatitis ◽  
Bowel Disease ◽  
Morphological Changes ◽  
Drug Induced ◽  
Inflammatory Bowel ◽  
Autoimmune Hepatitis Type 1 ◽  
New Onset

Abstract Background Elevated transaminases can occur in up to 17 per cent of cases of Inflammatory Bowel Disease (IBD)1, with many cases related to concurrent autoimmune conditions of the liver. Primary Sclerosing Cholangitis (PSC) is the most common autoimmune disease of the liver that is associated with IBD. Other causes of liver inflammation in patients with IBD can include Autoimmune Hepatitis (AIH). Aims We aim to report a case of new onset ulcerative colitis in a patient with autoimmune hepatitis type 1 in the absence of concomitant PSC. Methods Case report and review of literature. Results A 25-year-old male with painless jaundice and was found to have Autoimmune hepatitis type 1 with typical morphological changes, positive Antinuclear antibodies and elevated IgG levels. Histopathological exam of the liver did not show any direct changes to the bile ducts to suggest PSC. The patient was started on steroids and Mycophenolate Mofetil (MMF) and developed new onset diarrhea. Colonoscopy was performed and both endoscopic and pathological findings were suggestive of likely inflammatory bowel disease, although drug induced colitis (MMF) could not be excluded. Conclusions We conclude that there is a link between autoimmune hepatitis with IBD, in absence of concomitant PSC. Funding Agencies None

Infliximab-induced autoimmune hepatitis

2021 ◽  
Vol 14 (5) ◽  
pp. e239944
Author(s):  
Alexander Jenkins ◽  
Amy Austin ◽  
Kathryn Hughes ◽  
Brett Sadowski ◽  
Dawn Torres
Keyword(s):  
Autoimmune Hepatitis ◽  
Wide Spectrum ◽  
Inflammatory Disorder ◽  
Drug Induced ◽  
Necrosis Factor Alpha ◽  
Treatment Regimens ◽  
Circulating Antibodies ◽  
Inflammatory Bowel ◽  
Factor Alpha ◽  
Necrosis Factor

Autoimmune hepatitis (AIH) is an inflammatory disorder of the liver with a wide spectrum of disease presentation, from asymptomatic elevations in liver-associated enzymes to acute liver failure. AIH is classically associated with elevated immunoglobulins and autoantibodies, although approximately 20% of patients with features of AIH lack circulating antibodies. Recently, tumour necrosis factor alpha inhibitors have been implicated in several cases of drug-induced AIH which impact treatment regimens for patients with inflammatory bowel disease (IBD). We present a case of infliximab-induced seronegative AIH responding to budesonide therapy with successful alteration of IBD treatment regimen to vedolizumab.

scholarly journals Bittersweet: infective complications of drug-induced glycosuria in patients with diabetes mellitus on SGLT2-inhibitors: two case reports

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Caroline Bartolo ◽  
Victoria Hall ◽  
N. Deborah Friedman ◽  
Chloe Lanyon ◽  
Andrew Fuller ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Fungal Infections ◽  
Case Reports ◽  
Sglt2 Inhibitor ◽  
Sglt2 Inhibitors ◽  
Urogenital Tract ◽  
Hypoglycemic Agents ◽  
Drug Induced ◽  
First Case ◽  
Increased Risk

Abstract Background Sodium-glucose co-transporter 2 (SGLT2) inhibitors are novel hypoglycemic agents which reduce reabsorption of glucose at the renal proximal tubule, resulting in significant glycosuria and increased risk of genital mycotic infections (GMI). These infections are typically not severe as reported in large systematic reviews and meta-analyses of the medications. These reviews have also demonstrated significant cardiovascular benefits through other mechanisms of action, making them attractive options for the management of Type 2 diabetes mellitus (T2DM). We present two cases with underlying abnormalities of the urogenital tract in which the GMI were complicated and necessitated cessation of the SGLT2 inhibitor. Case presentations Both cases are patients with T2DM on empagliflozin, an SGLT2 inhibitor. The first case is a 64 year old man with Candida albicans balanitis and candidemia who was found to have an obstructing renal calculus and prostatic abscess requiring operative management. The second case describes a 72 year old man with Candida glabrata candidemia who was found to have prostatomegaly, balanitis xerotica obliterans with significant urethral stricture and bladder diverticulae. His treatment was more complex due to fluconazole resistance and concerns about urinary tract penetration of other antifungals. Both patients recovered following prolonged courses of antifungal therapy and in both cases the SGLT2 inhibitor was ceased. Conclusions Despite their cardiovascular benefits, SGLT2 inhibitors can be associated with complicated fungal infections including candidemia and patients with anatomical abnormalities of the urogenital tract may be more susceptible to these infections as demonstrated in these cases. Clinicians should be aware of their mechanism of action and associated risk of infection and prior to prescription, assessment of urogenital anatomical abnormalities should be performed to identify patients who may be at risk of complicated infection.

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