The successful treatment of autoimmune hepatitis with 6-mercaptopurine after failure with azathioprine.
Although the treatment of choice for autoimmune hepatitis is glucocorticoids, their side effects make long-term use undesirable. Therefore, other immunosuppressive agents have been used to replace glucocorticoids in the long-term treatment of autoimmune hepatitis, including azathioprine, a purine analogue. It is derived from 6-mercaptopurine, and these two drugs are often used interchangeably. However, these drugs have different toxicity profiles and may have clinically relevant differences in immunosuppressive activity in individual patients. We report 3 patients with autoimmune hepatitis who either could not tolerate or failed to improve on azathioprine but responded well to 6-mercaptopurine.
Division of Gastroenterology, New England Medical Center, Boston, Massachusetts, USA.
D S
DS
Pratt
D P
DP
Flavin
M M
MM
Kaplan
D000293:Adolescent; D000328:Adult; D001327:Autoimmune Diseases / Q000188:drug therapy*; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006505:Hepatitis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D015122:Mercaptopurine / Q000627:therapeutic use*; D012074:Remission Induction
D015122:Mercaptopurine; D001379:Azathioprine