Rapid-onset Primary Biliary Cirrhosis Resembling Drug-induced Liver Injury

Tetsuro SOHDA; Hiroshi SHIGA; Hidetoshi NAKANE; Shinya NISHIZAWA; Makoto YOSHIKANE; Akira ANAN; Norihisa SUZUKI; Makoto IRIE; Kaoru IWATA; Hiroshi WATANABE; Shotaro SAKISAKA

doi:10.2169/internalmedicine.44.1051

CASE REPORTS

Rapid-onset Primary Biliary Cirrhosis Resembling Drug-induced Liver Injury

Tetsuro SOHDA, Hiroshi SHIGA, Hidetoshi NAKANE, Shinya NISHIZAWA, Makoto YOSHIKANE, Akira ANAN, Norihisa SUZUKI, Makoto IRIE, Kaoru IWATA, Hiroshi WATANABE, Shotaro SAKISAKA

Author information

Tetsuro SOHDA
Third Department of Medicine, Fukuoka University School of Medicine
Hiroshi SHIGA
Third Department of Medicine, Fukuoka University School of Medicine
Hidetoshi NAKANE
Third Department of Medicine, Fukuoka University School of Medicine
Shinya NISHIZAWA
Third Department of Medicine, Fukuoka University School of Medicine
Makoto YOSHIKANE
Third Department of Medicine, Fukuoka University School of Medicine
Akira ANAN
Third Department of Medicine, Fukuoka University School of Medicine
Norihisa SUZUKI
Third Department of Medicine, Fukuoka University School of Medicine
Makoto IRIE
Third Department of Medicine, Fukuoka University School of Medicine
Kaoru IWATA
Third Department of Medicine, Fukuoka University School of Medicine
Hiroshi WATANABE
Third Department of Medicine, Fukuoka University School of Medicine
Shotaro SAKISAKA
Third Department of Medicine, Fukuoka University School of Medicine

Keywords: primary biliary liver cirrhosis (PBC), overlap syndrome, rapid onset, diet product, drug-induced liver injury

JOURNAL OPEN ACCESS

2005 Volume 44 Issue 10 Pages 1051-1054

DOI https://doi.org/10.2169/internalmedicine.44.1051

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Abstract

A 54-year-old woman was admitted to our hospital because of acute liver injury. Since she had a history of having used a diet product, drug-induced liver injury (DILI) was initially considered. However, the patient was subsequently diagnosed as suffering from primary biliary cirrhosis (PBC) based on the findings of liver histology and serum anti-mitochondrial antibody positivity. Overlap syndrome between PBC and autoimmune hepatitis (AIH) was also suspected, however, serum levels of aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase became normal three months later, after treatment with combination therapy comprising ursodeoxycholic acid plus bezafibrate. We therefore concluded that the liver disease in this patient was actually PBC, but that it resembled overlap syndrome or DILI. In cases of PBC, a rapid onset, as frequently seen in the case of DILI, viral hepatitis or AIH, is not common. We herein report a rare case of PBC which resembled DILI.

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