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Autoimmune cholangitis with features of autoimmune hepatitis: Successful treatment with immunosuppressive agents and ursodeoxycholic acid
Author(s) -
Li ChungPin,
Tong Myron J,
Hwang ShinnJang,
Luo JiingChyuan,
Co Ruth L,
Tsay ShyhHaw,
Chang FullYoung,
Lee ShouDong
Publication year - 2000
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2000.02054.x
Subject(s) - ursodeoxycholic acid , medicine , autoimmune hepatitis , prednisone , azathioprine , liver biopsy , gastroenterology , anti nuclear antibody , hepatitis , primary biliary cirrhosis , centrilobular necrosis , antibody , immunology , autoantibody , biopsy , liver injury , disease
We report a 42‐year‐old Chinese female with elevated serum levels of liver aminotransferases, alkaline phosphatase, γ‐glutamyl transpeptidase, cholesterol and immunoglobulin M. Serum antimitochondrial antibody was negative, but antinuclear antibody was strongly positive. Liver histology showed features of both autoimmune cholangitis and autoimmune hepatitis. Combination therapy with immunosuppressive (prednisone and azathioprine) and choleuretic agents (ursodeoxycholic acid) was given. Serum aminotransferases and biliary enzymes showed much improvement after treatment. A follow‐up liver biopsy showed improvement of both hepatic necroinflammation and bile duct damage. Biliary enzymes rose after withdrawal of the immunosuppressive agents and declined again with reinstitution of prednisone. This case demonstrates that a combination of immunosuppressive agents and ursodeoxycholic acid may effectively treat patients with features of both autoimmune cholangitis and autoimmune hepatitis.