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Published on: February 3, 2012
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Pantoprazole-induced autoimmune chronic hepatitis
Lucy Meunier1, Jose Ursic-Bedoya1, Georges-Philippe Pageaux1
1Liver and Transplantation Unit, Montpellier School of Medicine and IRB-INSERM-1183, Montpellier, France.
Summary
Pantoprazole can cause acute liver injury and autoimmune hepatitis. This rare drug-induced liver condition resolved with immunosuppressive treatment, highlighting a new potential side effect.
Area of Science:
- Hepatology
- Clinical Pharmacology
- Immunology
Background:
- Pantoprazole, a proton pump inhibitor, is rarely associated with acute hepatitis.
- The potential for pantoprazole to induce chronic autoimmune hepatitis has not been previously documented.
Observation:
- A patient developed acute liver injury with jaundice and autoimmune features after 2 months of pantoprazole.
- Liver biopsy showed hepatocellular lesions, cholestasis, acute cholangitis, and inflammation suggestive of drug-induced liver injury.
- While jaundice resolved upon pantoprazole withdrawal, chronic autoimmune liver injury and fibrosis developed.
Findings:
- Pantoprazole administration was linked to acute hepatocellular hepatitis, acute cholangitis, and autoimmune liver injury.
- The patient experienced extensive liver fibrosis within months, indicating chronic autoimmune liver injury.
- Immunosuppressive therapy led to complete recovery and autoantibody disappearance.
Implications:
- This case suggests pantoprazole can trigger acute cholangitis and autoimmune liver injury.
- It demonstrates that certain drug-induced liver injuries can manifest as chronic autoimmune hepatitis.
- Successful treatment with immunosuppressants offers a therapeutic approach for this rare condition.
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