Mycophenolate mofetil as an alternative treatment for autoimmune hepatitis.
- Author:
Seung Woon PARK
1
;
Soon Ho UM
;
Han Ah LEE
;
Sang Hyun KIM
;
Yura SIM
;
Sun Young YIM
;
Yeon Seok SEO
;
Ho Sang RYU
Author Information
- Publication Type:Case Reports
- Keywords: Mycophenolate mofetil; Autoimmune hepatitis; Azathioprine
- MeSH: Alanine Transaminase/analysis; Alopecia/etiology; Antibiotics, Antineoplastic/*therapeutic use; Aspartate Aminotransferases/analysis; Azathioprine/adverse effects; Female; Hepatitis, Autoimmune/*drug therapy/pathology; Humans; Liver/enzymology/pathology; Middle Aged; Mycophenolic Acid/*therapeutic use; Pancytopenia/etiology; Prednisolone/therapeutic use
- From:Clinical and Molecular Hepatology 2016;22(2):281-285
- CountryRepublic of Korea
- Language:English
- Abstract: 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.
