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Refractory Autoimmune Hepatitis: Beyond Standard Therapy

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Abstract

Autoimmune hepatitis (AIH) can be difficult to control, particularly in some African-Americans. When standard therapy of prednisone and azathioprine is ineffective or poorly tolerated, alternative therapies are resorted to. We report two patients with AIH who were refractory to or intolerant of standard therapy. They initially responded to a combination of tacrolimus and MMF, but eventually developed acute flares of the disease that had to be managed with sirolimus, and in one case, rituximab, to achieve remission.

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Abbreviations

AA:

African-American

AIH:

Autoimmune hepatitis

ALT:

Alanine transaminase

AST:

Aspartate transaminase

ANA:

Antinuclear antibody

ASMA:

Antismooth muscle antibody

ITP:

Idiopathic thrombocytopenic purpura

MMF:

Mycophenolate mofetil

TB:

Total bilirubin

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Authors and Affiliations

  1. Section of Hospital Medicine, Department of Medicine, University of Chicago Medicine, 5841 S. Maryland Ave., MC 5000, Chicago, IL, 60637, USA

    Jonah N. Rubin

  2. Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Chicago Medicine, 5841 S. Maryland Ave., MC 7120, Chicago, IL, 60637, USA

    Helen S. Te

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Correspondence to Helen S. Te.

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Rubin, J.N., Te, H.S. Refractory Autoimmune Hepatitis: Beyond Standard Therapy. Dig Dis Sci 61, 1757–1762 (2016). https://doi.org/10.1007/s10620-015-4022-0

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  • DOI: https://doi.org/10.1007/s10620-015-4022-0

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