title: Use of a xanthine oxidase inhibitor in autoimmune hepatitis.
abstract: A 62-year-old woman with type 1 autoimmune hepatitis (AIH) failed to sustain remission when steroids were withdrawn from a regimen of steroids and azathioprine (AZA). Thiopurine metabolites revealed elevated 6-MMP (6-methyl mercaptopurine) and low 6-TGN (6-thioguanine nucleotide) consistent with AZA-induced hepatotoxicity. Introducing the xanthine oxidase inhibitor allopurinol led to rapid normalization of alanine aminotransferase (ALT) and discontinuation of steroids.
authors.affiliation: Department of Gastroenterology, Royal Bournemouth Hospital, Bournemouth, UK. safa.al-shamma@rbch.nhs.uk
authors.forename: Safa
authors.initials: S
authors.lastname: Al-Shamma
authors.forename: Balint
authors.initials: B
authors.lastname: Eross
authors.forename: Simon
authors.initials: S
authors.lastname: Mclaughlin
mesh_terms: D000493:Allopurinol / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D019693:Hepatitis, Autoimmune / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D016896:Treatment Outcome; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors*
chemical_list: D004791:Enzyme Inhibitors; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D000493:Allopurinol; D011239:Prednisolone; D014969:Xanthine Oxidase; D001379:Azathioprine