Concurrent autoimmune hepatitis in multiple sclerosis

Mult Scler. 2018 Mar;24(3):350-353. doi: 10.1177/1352458517692885. Epub 2017 Feb 1.

Abstract

Background: Autoimmune hepatitis (AIH) is a rare and chronic inflammatory disorder associated with extrahepatic autoimmune diseases, including, infrequently, multiple sclerosis (MS). Short Reports: We report five cases of MS and AIH association. One patient developed AIH while under interferon beta-1b and the remaining while off disease-modifying therapy, although after methylprednisolone bolus in three. All presented a liver biopsy compatible with AIH. Hepatitis resolution was achieved with immunosuppressive treatment, but one patient died after a fulminant hepatitis requiring liver transplant.

Discussion: A thorough review of published cases supports this clear, although rare, association and a liver biopsy should be considered in AIH suspected cases.

Keywords: Multiple sclerosis; autoimmune hepatitis; disease-modifying therapy; high-dose intravenous steroids; liver biopsy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Comorbidity
  • Female
  • Hepatitis, Autoimmune / diagnosis*
  • Hepatitis, Autoimmune / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting / diagnosis*
  • Multiple Sclerosis, Relapsing-Remitting / epidemiology