[Autoimmune hepatitis treated with cyclosporin revealed by acute hepatocellular failure].
BACKGROUND
Autoimmune hepatitis (AIH), usually chronic hepatitis, can be revealed by an acute episode of hepatic failure not easily treatable.


METHODS
A 4 year-old boy presented with severe acute hepatic failure (AHF) without hypergammaglobulinemia, revealing AIH. A triple immunosuppressive treatment (prednisolone, azathioprine, ciclosporine) was started when clinical and biological signs worsened (prothrombin time 18%, factor V 32%). Liver functions significantly improved within 10 days, although complications due to intensive immunosuppression occurred (Candida septicemia).


CONCLUSIONS
AIH must be evocated in each case of AHF. Some observations of AIH treated with ciclosporine are published but protocols of its administration are variable: ciclosporine is used alone or associated with other drugs, in first intention or secondarily, when the classical treatment is contra-indicated or fails. Controlled studies are needed to precise ciclosporine indications in AIH and to propose the best protocol.
Launay
V
V
Service de pédiatrie, hôpital Claude-Huriez, Lille, France.
Gottrand
F
F
Michaud
L
L
Masy
E
E
Turck
D
D
Farriaux
J P
JP
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000188:drug therapy*; D001379:Azathioprine / Q000627:therapeutic use; D002675:Child, Preschool; D002908:Chronic Disease; D016572:Cyclosporine / Q000627:therapeutic use*; D006505:Hepatitis / Q000150:complications / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017114:Liver Failure, Acute / Q000209:etiology*; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D001379:Azathioprine
Traitement par la ciclosporine d'une hépatite auto-immune révélée par une insuffisance hépatocellulaire aiguë.