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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

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.

Keywords

Refractory autoimmune hepatitis Sirolimus Rapamycin Tacrolimus Rituximab 

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

Notes

Compliance with ethical standards

Conflict of interest

None.

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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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