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Hepatitis01:25

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Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver. The...
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Related Experiment Video

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Induction of Drug-Induced, Autoimmune Hepatitis in BALB/c Mice for the Study of Its Pathogenic Mechanisms
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Published on: May 29, 2020

Mycophenolate mofetil for autoimmune hepatitis: a single practice experience.

David C Wolf1, Lizza Bojito, Marcelo Facciuto

  • 1Division of Gastroenterology and Hepatobiliary Diseases, New York Medical College, Valhalla, NY 10595, USA. david_wolf@nymc.edu

Digestive Diseases and Sciences
|December 17, 2008
PubMed
Summary

Mycophenolate mofetil (MMF) offers a safe alternative for autoimmune hepatitis (AIH) patients unresponsive to standard treatments. This immunosuppressant effectively reduced liver enzymes and allowed for lower prednisone doses in refractory cases.

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Area of Science:

  • Hepatology
  • Immunology
  • Pharmacology

Background:

  • Autoimmune hepatitis (AIH) is refractory to standard prednisone and azathioprine therapy in approximately 20% of patients.
  • Alternative immunosuppressants are being investigated for difficult-to-treat AIH cases.
  • Mycophenolate mofetil (MMF) is an alternative immunosuppressant explored for AIH management.

Purpose of the Study:

  • To assess the efficacy and safety of MMF in patients diagnosed with AIH and related liver disorders.
  • To evaluate MMF as a potential alternative to azathioprine for patients intolerant or refractory to standard therapy.

Main Methods:

  • A retrospective analysis was conducted on 16 patients with AIH, immune cholangitis, or overlap syndromes.
  • MMF was administered as a substitute for azathioprine due to intolerance, refractory disease, or perceived efficacy.
  • Outcomes measured included alanine aminotransferase (ALT) levels, prednisone dosage, and patient tolerance.

Main Results:

  • Median ALT levels significantly decreased from 81.5 U/l to 42.5 U/l (P=0.03) after MMF initiation.
  • Median prednisone dose was reduced from 10 mg to 2.5 mg (P=0.01), with complete withdrawal in three patients.
  • Biochemical remission (ALT < 2x normal) was achieved in 31% of patients, and 44% were maintained in remission. MMF was well-tolerated, with only one patient discontinuing due to paresthesias.

Conclusions:

  • MMF demonstrates potential as a safe and effective alternative immunosuppressant for patients with AIH and related conditions.
  • The study suggests MMF can help reduce liver inflammation and reliance on corticosteroids in refractory AIH.
  • Further prospective studies are warranted to confirm MMF's role in AIH treatment algorithms.