Mycophenolate mofetil for the treatment of autoimmune hepatitis in patients refractory to standard therapy

被引:88
作者
Devlin, SM
Swain, MG
Urbanski, SJ
Burak, KW
机构
[1] Univ Calgary, Hlth Sci Ctr, Med Clin, Calgary, AB T2N 4N1, Canada
[2] Univ Calgary, Liver Unit, Div Gastroenterol, Calgary, AB T2N 4N1, Canada
[3] Univ Calgary, Dept Pathol, Calgary, AB T2N 4N1, Canada
关键词
autoimmune hepatitis; Mycophenolic acid; steroid sparing; therapy;
D O I
10.1155/2004/504591
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
There are limited therapeutic options available for patients with autoimmune hepatitis in whom conventional treatment fails. A case series of five patients Unresponsive to or unable to take azathioprine, 6-mercaptopurine or corticosteroids who wore treated with mycophenolate mofetil (MMF) is reported. While on MMF, alanine aminotransferase normalized or remained normal in all patients. MMF had a steroid-sparing effect and histological remission was demonstrated in one patient after seven months of MMF. One patient experienced an uncomplicated episode of pyelonephritis. In conclusion, MMF call effectively induce and maintain remission in refractory autoimmune hepatitis patients.
引用
收藏
页码:321 / 326
页数:6
相关论文
共 46 条
[1]   International Autoimmune Hepatitis Group Report:: review of criteria for diagnosis of autoimmune hepatitis [J].
Alvarez, E ;
Berg, PA ;
Bianchi, FB ;
Bianchi, L ;
Burroughs, AK ;
Cancado, EL ;
Chapman, RW ;
Cooksley, WGE ;
Czaja, AJ ;
Desmet, VJ ;
Donaldson, RT ;
Eddleston, ALWF ;
Fainboim, L ;
Heathcote, J ;
Homberg, JC ;
Hoofnagle, JH ;
Kakumu, S ;
Krawitt, EL ;
Mackay, IR ;
MacSween, RNM ;
Maddrey, WC ;
Manns, MP ;
McFarlane, IG ;
zum Büschenfelde, KHM ;
Mieli-Vergani, G ;
Nakanuma, Y ;
Nishioka, M ;
Penner, E ;
Porta, G ;
Portmann, BC ;
Reed, WD ;
Rodes, J ;
Schalm, SW ;
Scheuer, PJ ;
Schrumpf, E ;
Seki, T ;
Toda, G ;
Tsuji, T ;
Tygstrup, N ;
Vergani, D ;
Zeniya, M .
JOURNAL OF HEPATOLOGY, 1999, 31 (05) :929-938
[2]  
Boberg KM, 1998, SCAND J GASTROENTERO, V33, P99
[3]  
BUBERG KM, 2002, CLIN LIVER DIS, V6, P347
[4]   Successful treatment of refractory type 1 autoimmune hepatitis with methotrexate [J].
Burak, KW ;
Urbanski, SJ ;
Swain, MG .
JOURNAL OF HEPATOLOGY, 1998, 29 (06) :990-993
[5]   CONTROLLED PROSPECTIVE TRIAL OF CORTICOSTEROID THERAPY IN ACTIVE CHRONIC HEPATITIS [J].
COOK, GC ;
MULLIGAN, R ;
SHERLOCK, S .
QUARTERLY JOURNAL OF MEDICINE, 1971, 40 (158) :159-+
[6]   Diagnosis and treatment of autoimmune hepatitis [J].
Czaja, AJ ;
Freesel, DK .
HEPATOLOGY, 2002, 36 (02) :479-497
[7]   Ursodeoxycholic acid as adjunctive therapy for problematic type 1 autoimmune hepatitis: A randomized placebo-controlled treatment trial [J].
Czaja, AJ ;
Carpenter, HA ;
Lindor, KD .
HEPATOLOGY, 1999, 30 (06) :1381-1386
[8]   Failure of budesonide in a pilot study of treatment-dependent autoimmune hepatitis [J].
Czaja, AJ ;
Lindor, KD .
GASTROENTEROLOGY, 2000, 119 (05) :1312-1316
[9]  
Eckhoff DE, 1998, TRANSPLANTATION, V65, P180
[10]  
Fellermann K, 2000, ALIMENT PHARM THER, V14, P171