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Use of a xanthine oxidase inhibitor in autoimmune hepatitis
Author(s) -
AlShamma Safa,
Eross Balint,
Mclaughlin Simon
Publication year - 2013
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.26198
Subject(s) - medicine , autoimmune hepatitis , anti nuclear antibody , gastroenterology , liver function tests , hepatitis , prednisolone , azathioprine , anti neutrophil cytoplasmic antibody , immunology , endocrinology , antibody , autoantibody , vasculitis , disease
A 62-year-old woman with type 1 autoimmune hepatitis (AIH) failed to sustain remission when steroids were withdrawn from a regimen of steroids and azathioprine (AZA).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.