Histological changes after the use of mycophenolate mofetil in autoimmune hepatitis.
Corticosteroids and azathioprine are considered standard treatment for autoimmune hepatitis. There are, however, well-known systemic side effects that may preclude continuation with these immunosuppressive therapies, and small trials of the anti-metabolite mycophenolate mofetil have been reported. We report liver biopsy findings in a follow-up biopsy of a patient who had been switched from azathioprine to mycophenolate mofetil for treatment of presumed, steroid-responsive autoimmune hepatitis. Both cytoplasmic features of adaptation and nuclear alterations were noted in hepatocytes. Possible mechanisms for these findings are discussed.
Brunt
Elizabeth M
EM
Saint Louis University Liver Center, Saint Louis University Health Sciences Center, St. Louis, MO, USA.
Di Bisceglie
Adrian M
AM
D001379:Azathioprine / Q000627:therapeutic use; D005260:Female; D019693:Hepatitis, Autoimmune / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D011241:Prednisone / Q000627:therapeutic use
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D001379:Azathioprine; D011241:Prednisone