Bosentan Inducing Autoimmune Hepatitis in a Patient with Idiopathic Pulmonary Arterial Hypertension

Abstract

A 41-year-old woman diagnosed with idiopathic pulmonary hypertension presented symptoms despite the use of vasodilators, requiring treatment with bosentan. Previously, the patient had no signs of autoimmunity and had normal liver function. After three years of bosentan use, aminotransferase levels increased, without improvement after bosentan suspension, leading to complementary investigation. The diagnosis of autoimmune hepatitis was confirmed by biopsy, already in the stage of cirrhosis. In conclusion, in case of aminotransferase levels that remain persistently elevated, despite the reduction in doses and/or suspension of bosentan, autoimmune hepatitis must be investigated and treated urgently due to possibly rapid progression to cirrhosis..

Natural Products for the Treatment of Pulmonary Hypertension: Mechanism, Progress, and Future Opportunities

“…These drugs improve patient prognosis moderately, but their clinical application is limited. Bosentan causes liver damage, and sildenafil has age restrictions [ 9 , 10 ]. In addition, these drugs are simply designed from a single target, which limits their clinical applications.…”