Autoimmune hepatitis
Article Abstract:
Autoimmune hepatitis may be effectively treated with long-term immunosuppressive drug therapy, but it must be diagnosed early. For many years autoimmune hepatitis went undiagnosed because it could not be distinguished from viral hepatitis. Diagnosis may be made based on tests for various antibodies and, in some cases, the appearance of symptoms of acute hepatitis. Therapy should involve prednisone and azathioprine. A 1995 study showed that azathioprine was more effective than prednisone in maintaining remission after initial treatment with both. However prednisone may cause obesity and osteoporosis and azathioprine increases the risk of cancer. These side effects must be balanced. Patients who are not in complete remission or who do not tolerate azathioprine may be treated with cyclosporine or cyclophosphamide. Furthermore, all cases of autoimmune hepatitis, including mild ones, should be treated until remission is evidenced in biochemical tests. The results of the 1995 trial may be applicable to similar autoimmune disorders.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1995
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Autoimmune hepatitis
Article Abstract:
Autoimmune hepatitis is an inflammation of the liver that is characterized by autoantibodies and progressive fibrosis and cirrhosis of the liver. Its cause is unknown, but it is thought that an environmental agent enhances a genetic susceptibility to produce antibodies against liver cells. Most patients have antibodies against the nucleus, smooth muscle cells and actin. The asialoglycoprotein receptor, which is unique to the liver, may also be the target of autoimmune attack. There are data supporting a possible defect in suppressor T cell function. Some patients will have no symptoms, but many have elevated levels of gamma globulins, which are a type of antibody. Patients with symptoms should be treated with corticosteroids, alternated with azathioprine, which can reduce the side effects of corticosteroids. Remission rates as high as 80% can be achieved and many patients will remain in remission when the drugs are discontinued. Liver transplant can be an effective treatment for those with advanced disease.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1996
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Autoimmune diseases
Article Abstract:
The genetic and environmental causes of autoimmune diseases are reviewed and specific treatments are given for rheumatoid arthritis, multiple sclerosis, psoriasis, type 1 diabetes, and systemic lupus erythematosus.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2001
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