title: Rituximab for refractory autoimmune hepatitis: a case report.
abstract: Auto-immune hepatitis (AIH) is a chronic progressive hepatitis of unknown aetiology whose clinical presentation ranges from asymptomatic to fulminant hepatic failure. Corticosteroids and azathioprine, which are considered standard therapy for AIH, may, however, be associated with treatment failures and toxicities. Among the alternative medications under investigation, rituximab, used to treat successfully various auto-immune disorders, has fewer side effects. We report herein the case of a 68-year-old woman who developed AIH with worsening clinical, laboratory and histological features despite high-dose prednisone. On rituximab, the patient showed rapid and dramatic clinical improvement, suggesting a therapeutic role for this medication in severe AIH. Indeed, prospective controlled studies are needed to assess and validate this role.
authors.affiliation: Hepatology Unit, Department of Gastroenterology, Royal Victoria Hospital, McGill University Health Center, Montreal, QC, Canada; Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Al-Khoudh, Oman. Electronic address: said_albusafi@yahoo.com.
authors.forename: Said A
authors.initials: SA
authors.lastname: Al-Busafi
authors.forename: René P
authors.initials: RP
authors.lastname: Michel
authors.forename: Marc
authors.initials: M
authors.lastname: Deschenes
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D005260:Female; D019693:Hepatitis, Autoimmune / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D011241:Prednisone / Q000627:therapeutic use; D000069283:Rituximab; D017211:Treatment Failure
chemical_list: D000893:Anti-Inflammatory Agents; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab; D011241:Prednisone
keywords: Auto-immune; Hepatitis; Rituximab