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Treatment Side Effects and Associated Autoimmune Diseases

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Book cover Autoimmune Hepatitis

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

A wide variety of immunosuppressants and immunomodulators have been used to treat autoimmune hepatitis. Prednisone or prednisolone, alone or in combination with azathioprine is the treatment mainstay, limited mostly by the development of drug toxicity. In that regard, combination therapy is associated with fewer side effects than prednisone monotherapy (10 versus 44%). In approximately 10% of the cases treatment with prednisone/azathioprine will fail and use of alternative therapy will be necessary. This chapter will review the most common side effects of these drugs used in the treatment of autoimmune hepatitis followed by a discussion regarding associated autoimmune diseases.

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Abbreviations

6-MMP:

6-Methylmercaptopurine

6-MP:

6-Mercaptopurine

6-TGN:

6-Thioguanine nucleotides

AIRE:

Autoimmune regulator

APECED:

Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy

APS:

Autoimmune polyglandular syndromes

AZA:

Azathioprine

CREST:

Subcutaneous calcinosis, Raynaud’s phenomenon, esophageal dysfunction, sclerodactyly and telangectasias

CTLA-4:

Cytotoxic T lymphocyte antigen-4

HLA:

Histocompatibility leukocyte antigen

IBD:

Inflammatory bowel disease

NRH:

Nodular regenerative hyperplasia

PBC:

Primary biliary cirrhosis

PSC:

Primary sclerosing cholangitis

RA:

Rheumatoid arthritis

SLE:

Systemic lupus erythematosus

SS:

Systemic sclerosis

TNF:

Tumor necrosis factor

TPMT:

Thiopurine methyltransferase

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Authors and Affiliations

  1. Division of Hepatology, University of Miami School of Medicine, 1500 NW 12th Avenue, Suite 1101, Miami, 33136, FL, USA

    Cynthia Levy

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  1. Toronto Western Hospital Liver Centre, Department of Medicine, University of Toronto, Bathhurst St. 399, Toronto, M5T 2S8, Ontario, Canada

    Gideon M. Hirschfield

  2. Toronto Western Hospital Liver Centre, University of Toronto, Bathhurst St. 399, Toronto, M5T 2S8, Ontario, Canada

    E. Jenny Heathcote

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Levy, C. (2012). Treatment Side Effects and Associated Autoimmune Diseases. In: Hirschfield, G., Heathcote, E. (eds) Autoimmune Hepatitis. Clinical Gastroenterology. Springer, New York, NY. https://doi.org/10.1007/978-1-60761-569-9_11

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