Hepatitis C virus-associated fibrosing cholestatic hepatitis after renal transplantation: response to interferon-alpha therapy.
Hepatitis C virus-associated fibrosing cholestatic hepatitis after renal transplantation: response to interferon-alpha therapy.
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DOI：
10.1097/00007890-199811150-00023
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发表时间：
1998-11
期刊：
影响因子：
6.2
通讯作者：
C. M. Toth;M. Pascual;R. Chung;F. Graeme-Cook;J. Dienstag;A. Bhan;A. Cosimi
中科院分区：
文献类型：
--
作者：
C. M. Toth;M. Pascual;R. Chung;F. Graeme-Cook;J. Dienstag;A. Bhan;A. Cosimi
纤维性淤胆性肝炎(FCH)最近被描述为丙型肝炎病毒(丙型肝炎)感染患者的实体器官移植后。典型的FCH的特点是，如果不进行肝移植，其不祥的临床病程会导致进行性肝衰竭和死亡。2例丙型肝炎病毒感染者接受了身体肾移植治疗膜性肾病和糖尿病肾病所致的终末期肾病。两例患者从移植到确诊为FCH的时间间隔分别为7个月和10年。两名患者均出现黄疸、高胆红素血症和血清天冬氨酸氨基转移酶轻度至中度升高。一名患者还被发现患有II型混合性冷球蛋白血症。在肝活检确诊FCH后，开始α-干扰素治疗。肝脏检查异常迅速恢复正常。当丙型肝炎病毒感染的同种异体器官移植受者出现淤胆性肝脏恶化时，应考虑FCH的诊断并进行肝脏活检。我们的观察表明，FCH对抗病毒治疗有反应。
Fibrosing cholestatic hepatitis (FCH) has recently been described after solid organ transplantation in patients with hepatitis C virus (HCV) infection. Typically, FCH is characterized by an ominous clinical course leading to progressive hepatic failure and death if liver transplantation is not performed. Two HCV-infected patients underwent cadaveric renal transplantation for end-stage renal disease resulting from membranous nephropathy and diabetic nephropathy. The time intervals between transplantation and the biopsy diagnosis of FCH for the two patients were 7 months and 10 years. Both patients presented with jaundice, hyperbilirubinemia, and mild-to-moderate elevations in serum aspartate aminotransferase. One patient was also found to have type II mixed cryoglobulinemia. Interferon-alpha therapy was begun after a diagnosis of FCH was established by liver biopsy. Liver test abnormalities normalized rapidly. When cholestatic hepatic deterioration develops in an HCV-infected organ allograft recipient, the diagnosis of FCH should be considered and a liver biopsy performed. Our observations indicate that FCH can respond to antiviral therapy.