Mycophenolate mofetil as an alternative treatment for autoimmune hepatitis

Autoimmune hepatitis (AIH) is an immune-mediated chronic liver disease characterized by hepatocellular inflammation, necrosis, and fibrosis, which can progress to cirrhosis and fulminant hepatic failure. The standard treatment for AIH includes corticosteroids alone or in combination with azathioprin...

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Bibliographic Details
Published in:Clinical and molecular hepatology 2016, 22(2), , pp.281-285
Main Authors: Park, Seung Woon, Um, Soon Ho, Lee, Han Ah, Kim, Sang Hyun, Sim, Yura, Yim, Sun Young, Seo, Yeon Seok, Ryu, Ho Sang
Format: Article
Language:English
Subjects:
Alanine Transaminase - analysis
Alopecia
Alopecia - etiology
Antibiotics, Antineoplastic - therapeutic use
Antibodies
Aspartate Aminotransferases - analysis
Autoimmune hepatitis
Azathioprine
Azathioprine - adverse effects
Baldness
Blood
Bone marrow
Case Report
Drug dosages
Enzymes
Female
Hair
Hepatitis
Hepatitis, Autoimmune - drug therapy
Hepatitis, Autoimmune - pathology
Humans
Immunoglobulins
Inflammation
Liver - enzymology
Liver - pathology
Liver cirrhosis
Liver diseases
Middle Aged
Mycophenolate mofetil
Mycophenolic Acid - therapeutic use
Neutrophils
Pancytopenia - etiology
Patients
Phosphatase
Prednisolone - therapeutic use
Remission (Medicine)
Steroids
내과학
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Summary:Autoimmune hepatitis (AIH) is an immune-mediated chronic liver disease characterized by hepatocellular inflammation, necrosis, and fibrosis, which can progress to cirrhosis and fulminant hepatic failure. The standard treatment for AIH includes corticosteroids alone or in combination with azathioprine. Although most patients achieve remission using the standard regimen, some patients do not respond due to either drug intolerance or refractory disease; in such cases alternative immunosuppressive agents should be explored. The second-line therapies are cyclophilin inhibitors such as cyclosporine A or tacrolimus, and nowadays mycophenolate mofetil (MMF) is widely used if azathioprine-based therapies are not tolerated. Although these are recommended as an alternative to the first-line regimen, there is insufficient evidence for the efficacy of second-line therapies, with the evidence based mainly on expert opinion. Therefore, we report an AIH patient receiving the standard regimen in whom remission did not occur due to side effects to azathioprine, but was successfully treated with MMF in combination with corticosteroids as an alternative to the standard regimen.
ISSN:2287-2728
2287-285X
DOI:10.3350/cmh.2015.0040