Case report| Volume 2, ISSUE 1, P57-59, January 2013

Download started.


Suspected autoimmune hepatitis and primary biliary cirrhosis unmasked by interferon-beta in a multiple sclerosis patient


      The use of interferon-beta in multiple sclerosis is associated with various forms of hepatotoxicity, including autoimmune hepatitis and liver failure. We describe a case with features of autoimmune liver disease and primary biliary cirrhosis occurring during long-term treatment with interferon-beta in a patient with relapsing-remitting multiple sclerosis. This case highlights the importance of monitoring biochemical liver test results throughout interferon-beta treatment of multiple sclerosis.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Multiple Sclerosis and Related Disorders
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Bhandari B.M.
        • Bayat H.
        • Rothstein K.D.
        Primary biliary cirrhosis.
        Gastroenterology Clinics of North America. 2011; 40: 373-386
        • Boberg K.M.
        • Chapman R.W.
        • Hirschfield G.M.
        • Lohse A.W.
        • Manns M.P.
        • Schrumpf E.
        Overlap syndromes: the International Autoimmune Hepatitis Group (IAIHG) position statement on a controversial issue.
        Journal of Hepatology. 2011; 54: 374-385
        • Chazouilleres O.
        • Wendum D.
        • Serfaty L.
        • Montembault S.
        • Rosmorduc O.
        • Poupon R.
        Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome: clinical features and response to therapy.
        Hepatology. 1998; 28: 296-301
        • Durelli L.
        • Bongioanni M.R.
        • Ferrero B.
        • Oggero A.
        • Marzano A.
        • Rizzetto M.
        Interferon treatment for multiple sclerosis: autoimmune complications may be lethal.
        Neurology. 1998; 50: 570-571
        • Grieco A.
        • Montalto M.
        • Vero V.
        • Maria Vecchio F.
        • Gasbarrini G.
        Severe acute hepatitis after resumption of interferon-beta therapy for multiple sclerosis: a word of caution.
        American Journal of Gastroenterology. 2007; 102: 2606-2607
        • Hannuksela M.L.
        • Liisanantti M.K.
        • Nissinen A.E.
        • Savolainen M.J.
        Biochemical markers of alcoholism.
        Clinical Chemistry and Laboratory Medicine. 2007; 45: 953-961
      1. Health Canada. Hepatic injury associated with beta-interferon treatment for multiple sclerosis. Retrieved January 1, 2003 from 〈〉.

        • Invernizzi P.
        • Ransom M.
        • Raychaudhuri S.
        • Kosoy R.
        • Lleo A.
        • Shigeta R.
        • et al.
        Classical HLA-DRB1 and DPB1 alleles account for HLA associations with primary biliary cirrhosis.
        Genes and Immunity. 2012;
        • Mieli-Vergani G.
        • Vergani D.
        Autoimmune hepatitis.
        Nature Reviews Gastroenterology and Hepatology. 2011; 8: 320-329
        • Muratori P.
        • Muratori L.
        • Ferrari R.
        • Cassani F.
        • Bianchi G.
        • Lenzi M.
        • et al.
        Characterization and clinical impact of antinuclear antibodies in primary biliary cirrhosis.
        American Journal of Gastroenterology. 2003; 98: 431-437
        • Muratori L.
        • Granito A.
        • Muratori P.
        • Pappas G.
        • Bianchi F.P.
        Antimitochondrial antibodies and other antibodies in primary biliary cirrhosis: diagnostic and prognostic value.
        Clinics in Liver Disease. 2008; 12: 261-276
        • Poser C.M.
        • Paty D.W.
        • Scheinberg L.
        • McDonald W.I.
        • Davis F.A.
        • Ebers G.C.
        • et al.
        New diagnostic criteria for multiple sclerosis: guidelines for research protocols.
        Annals of Neurology. 1983; 13: 227-231
        • Pulicken M.
        • Koteish A.
        • DeBusk K.
        • Calabresi P.A.
        Unmasking of autoimmune hepatitis in a patient with MS following interferon beta therapy.
        Neurology. 2006; 66: 1954-1955
        • Tremlett H.L.
        • Yoshida E.M.
        • Oger J.
        Liver injury associated with the beta-interferons for MS: a comparison between the three products.
        Neurology. 2004; 62: 628-631
        • Yoshida E.M.
        • Rasmussen S.L.
        • Steinbrecher U.P.
        • Erb S.R.
        • Scudamore C.H.
        • Chung S.W.
        • et al.
        Fulminant liver failure during interferon beta treatment of multiple sclerosis.
        Neurology. 2001; 56: 1416