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Related Concept Videos

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Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
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Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
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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.
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Related Experiment Video

Updated: Mar 28, 2026

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Refractory Autoimmune Hepatitis: Beyond Standard Therapy.

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  • 1Section of Hospital Medicine, Department of Medicine, University of Chicago Medicine, 5841 S. Maryland Ave., MC 5000, Chicago, IL, 60637, USA.

Digestive Diseases and Sciences
|January 4, 2016
PubMed
Summary

Alternative therapies like tacrolimus, MMF, sirolimus, and rituximab show promise for difficult-to-control autoimmune hepatitis (AIH), especially in African-Americans unresponsive to standard prednisone and azathioprine treatment.

Keywords:
RapamycinRefractory autoimmune hepatitisRituximabSirolimusTacrolimus

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Area of Science:

  • Hepatology
  • Immunology
  • Internal Medicine

Background:

  • Autoimmune hepatitis (AIH) poses significant management challenges, particularly in certain African-American populations.
  • Standard treatment protocols involving prednisone and azathioprine are not universally effective or well-tolerated.

Observation:

  • Two cases of AIH refractory to or intolerant of standard therapy were analyzed.
  • Initial response was observed with a combination of tacrolimus and mycophenolate mofetil (MMF).

Findings:

  • Patients experienced acute disease flares despite initial response to tacrolimus and MMF.
  • Subsequent management with sirolimus, and in one case, rituximab, was required to achieve remission.

Implications:

  • This case series highlights the potential utility of alternative immunosuppressive agents in managing refractory AIH.
  • Further research into novel therapeutic strategies is warranted for complex AIH cases, including those in underrepresented demographics.