Digestive Diseases and Sciences

, Volume 61, Issue 6, pp 1757–1762 | Cite as

Refractory Autoimmune Hepatitis: Beyond Standard Therapy

  • Jonah N. Rubin
  • Helen S. TeEmail author
Case Report


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.


Refractory autoimmune hepatitis Sirolimus Rapamycin Tacrolimus Rituximab 





Autoimmune hepatitis


Alanine transaminase


Aspartate transaminase


Antinuclear antibody


Antismooth muscle antibody


Idiopathic thrombocytopenic purpura


Mycophenolate mofetil


Total bilirubin


Compliance with ethical standards

Conflict of interest



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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Section of Hospital Medicine, Department of MedicineUniversity of Chicago MedicineChicagoUSA
  2. 2.Section of Gastroenterology, Hepatology and Nutrition, Department of MedicineUniversity of Chicago MedicineChicagoUSA

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