Fibrosing cholestatic hepatitis in a hepatitis B surface antigen carrier after renal transplantation

Chien Hung Chen, Pei Jer Chen, Jan Show Chu, Kun Huei Yeh, Ming Yang Lai, Ding Shinn Chen

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

A 45-year-old hepatitis B surface antigen carrier had an allograft kidney transplantation and maintenance immunosuppression with cyclosporin A and predniso-lone. Six months later, she experienced a rapidly progressive hepatic failure manifested by elevation of serum bilirubin level, prolongation of prothrombin time, and mild to modest increase of serum aminotransferase levels. She died in 6 weeks. Postmortem liver histology showed canalicular and cellular cholestasis and ground-glass appearance and ballooning of most hepatocytes, but only mild inflammatory cell infiltration. Immunohistochemical staining showed massive loads of hepatitis B surface and core antigens in the hepatocytes and extensive periportal fibrosis. The whole picture was compatible with fibrosing cholestatic hepatitis described in hepatitis B virus-infected liver transplant. Sequencing of the hepatitis B virus genome amplified from the patient's serum indicated a precore mutant but few mutations in the core, pre-S, and S genes. Little inflammatory reaction was observed histologically despite HLA compatibility, a situation differing from that in liver transplant. This observation indicates that fibrosing cholestatic hepatitis may also occur in non-liver transplant setting.

Original languageEnglish
Pages (from-to)1514-1518
Number of pages5
JournalGastroenterology
Volume107
Issue number5
DOIs
Publication statusPublished - 1994
Externally publishedYes

Fingerprint

Hepatitis B Surface Antigens
Kidney Transplantation
Hepatitis
Transplants
Hepatitis B virus
Hepatocytes
Liver
Serum
Hepatitis B Core Antigens
Cholestasis
Prothrombin Time
Liver Failure
Transaminases
Bilirubin
Immunosuppression
Cyclosporine
Glass
Allografts
Histology
Fibrosis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Fibrosing cholestatic hepatitis in a hepatitis B surface antigen carrier after renal transplantation. / Chen, Chien Hung; Chen, Pei Jer; Chu, Jan Show; Yeh, Kun Huei; Lai, Ming Yang; Chen, Ding Shinn.

In: Gastroenterology, Vol. 107, No. 5, 1994, p. 1514-1518.

Research output: Contribution to journalArticle

Chen, Chien Hung ; Chen, Pei Jer ; Chu, Jan Show ; Yeh, Kun Huei ; Lai, Ming Yang ; Chen, Ding Shinn. / Fibrosing cholestatic hepatitis in a hepatitis B surface antigen carrier after renal transplantation. In: Gastroenterology. 1994 ; Vol. 107, No. 5. pp. 1514-1518.
@article{5f3ef8ee351e4490be61787422011248,
title = "Fibrosing cholestatic hepatitis in a hepatitis B surface antigen carrier after renal transplantation",
abstract = "A 45-year-old hepatitis B surface antigen carrier had an allograft kidney transplantation and maintenance immunosuppression with cyclosporin A and predniso-lone. Six months later, she experienced a rapidly progressive hepatic failure manifested by elevation of serum bilirubin level, prolongation of prothrombin time, and mild to modest increase of serum aminotransferase levels. She died in 6 weeks. Postmortem liver histology showed canalicular and cellular cholestasis and ground-glass appearance and ballooning of most hepatocytes, but only mild inflammatory cell infiltration. Immunohistochemical staining showed massive loads of hepatitis B surface and core antigens in the hepatocytes and extensive periportal fibrosis. The whole picture was compatible with fibrosing cholestatic hepatitis described in hepatitis B virus-infected liver transplant. Sequencing of the hepatitis B virus genome amplified from the patient's serum indicated a precore mutant but few mutations in the core, pre-S, and S genes. Little inflammatory reaction was observed histologically despite HLA compatibility, a situation differing from that in liver transplant. This observation indicates that fibrosing cholestatic hepatitis may also occur in non-liver transplant setting.",
author = "Chen, {Chien Hung} and Chen, {Pei Jer} and Chu, {Jan Show} and Yeh, {Kun Huei} and Lai, {Ming Yang} and Chen, {Ding Shinn}",
year = "1994",
doi = "10.1016/0016-5085(94)90557-6",
language = "English",
volume = "107",
pages = "1514--1518",
journal = "Gastroenterology",
issn = "0016-5085",
publisher = "W.B. Saunders Ltd",
number = "5",

}

TY - JOUR

T1 - Fibrosing cholestatic hepatitis in a hepatitis B surface antigen carrier after renal transplantation

AU - Chen, Chien Hung

AU - Chen, Pei Jer

AU - Chu, Jan Show

AU - Yeh, Kun Huei

AU - Lai, Ming Yang

AU - Chen, Ding Shinn

PY - 1994

Y1 - 1994

N2 - A 45-year-old hepatitis B surface antigen carrier had an allograft kidney transplantation and maintenance immunosuppression with cyclosporin A and predniso-lone. Six months later, she experienced a rapidly progressive hepatic failure manifested by elevation of serum bilirubin level, prolongation of prothrombin time, and mild to modest increase of serum aminotransferase levels. She died in 6 weeks. Postmortem liver histology showed canalicular and cellular cholestasis and ground-glass appearance and ballooning of most hepatocytes, but only mild inflammatory cell infiltration. Immunohistochemical staining showed massive loads of hepatitis B surface and core antigens in the hepatocytes and extensive periportal fibrosis. The whole picture was compatible with fibrosing cholestatic hepatitis described in hepatitis B virus-infected liver transplant. Sequencing of the hepatitis B virus genome amplified from the patient's serum indicated a precore mutant but few mutations in the core, pre-S, and S genes. Little inflammatory reaction was observed histologically despite HLA compatibility, a situation differing from that in liver transplant. This observation indicates that fibrosing cholestatic hepatitis may also occur in non-liver transplant setting.

AB - A 45-year-old hepatitis B surface antigen carrier had an allograft kidney transplantation and maintenance immunosuppression with cyclosporin A and predniso-lone. Six months later, she experienced a rapidly progressive hepatic failure manifested by elevation of serum bilirubin level, prolongation of prothrombin time, and mild to modest increase of serum aminotransferase levels. She died in 6 weeks. Postmortem liver histology showed canalicular and cellular cholestasis and ground-glass appearance and ballooning of most hepatocytes, but only mild inflammatory cell infiltration. Immunohistochemical staining showed massive loads of hepatitis B surface and core antigens in the hepatocytes and extensive periportal fibrosis. The whole picture was compatible with fibrosing cholestatic hepatitis described in hepatitis B virus-infected liver transplant. Sequencing of the hepatitis B virus genome amplified from the patient's serum indicated a precore mutant but few mutations in the core, pre-S, and S genes. Little inflammatory reaction was observed histologically despite HLA compatibility, a situation differing from that in liver transplant. This observation indicates that fibrosing cholestatic hepatitis may also occur in non-liver transplant setting.

UR - http://www.scopus.com/inward/record.url?scp=0027973405&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027973405&partnerID=8YFLogxK

U2 - 10.1016/0016-5085(94)90557-6

DO - 10.1016/0016-5085(94)90557-6

M3 - Article

C2 - 7926515

AN - SCOPUS:0027973405

VL - 107

SP - 1514

EP - 1518

JO - Gastroenterology

JF - Gastroenterology

SN - 0016-5085

IS - 5

ER -