title: Refractory Autoimmune Hepatitis: Beyond Standard Therapy.
abstract: Autoimmune hepatitis (AIH) can be difficult to control, particularly in some African-Americans. When standard therapy of prednisone and azathioprine is ineffective or poorly tolerated, alternative therapies are resorted to. We report two patients with AIH who were refractory to or intolerant of standard therapy. They initially responded to a combination of tacrolimus and MMF, but eventually developed acute flares of the disease that had to be managed with sirolimus, and in one case, rituximab, to achieve remission.
authors.affiliation: Section of Hospital Medicine, Department of Medicine, University of Chicago Medicine, 5841 S. Maryland Ave., MC 5000, Chicago, IL, 60637, USA.
authors.forename: Jonah N
authors.initials: JN
authors.lastname: Rubin
authors.affiliation: Section of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Chicago Medicine, 5841 S. Maryland Ave., MC 7120, Chicago, IL, 60637, USA. hte@medicine.bsd.uchicago.edu.
authors.forename: Helen S
authors.initials: HS
authors.lastname: Te
mesh_terms: D005260:Female; D019693:Hepatitis, Autoimmune / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents
keywords: Rapamycin; Refractory autoimmune hepatitis; Rituximab; Sirolimus; Tacrolimus