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. 1995 Mar;36(3):459–461. doi: 10.1136/gut.36.3.459

Cyclosporin in the treatment of corticosteroid resistant autoimmune chronic active hepatitis.

L D Jackson 1, E Song 1
PMCID: PMC1382466  PMID: 7698710

Abstract

A 17 year old Asian patient with autoimmune chronic active hepatitis resistant to treatment with high dose corticosteroids and azathioprine was given cyclosporin at a dose of 5 mg/kg/day. Within two weeks of starting the cyclosporin treatment a favourable clinical and biochemical response was obtained and by one month serum aminotransferase activities were within normal limits. An attempted reduction in the daily dose of cyclosporin resulted in a relapse of the patient's disease. Remission was again attained by returning the dose of cyclosporin to 5 mg/kg/day. No significant side effects of the treatment have been shown. Cyclosporin seems to have a role in the treatment of corticosteroid resistant autoimmune chronic active hepatitis and its further evaluation is warranted.

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Selected References

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  1. Bougnères P. F., Landais P., Boisson C., Carel J. C., Frament N., Boitard C., Chaussain J. L., Bach J. F. Limited duration of remission of insulin dependency in children with recent overt type I diabetes treated with low-dose cyclosporin. Diabetes. 1990 Oct;39(10):1264–1272. doi: 10.2337/diab.39.10.1264. [DOI] [PubMed] [Google Scholar]
  2. Bunjes D., Hardt C., Röllinghoff M., Wagner H. Cyclosporin A mediates immunosuppression of primary cytotoxic T cell responses by impairing the release of interleukin 1 and interleukin 2. Eur J Immunol. 1981 Aug;11(8):657–661. doi: 10.1002/eji.1830110812. [DOI] [PubMed] [Google Scholar]
  3. Cohen I. R., Wekerle H. Autosensitization of lymphocytes against thymus reticulum cells. Science. 1972 Jun 23;176(4041):1324–1325. doi: 10.1126/science.176.4041.1324. [DOI] [PubMed] [Google Scholar]
  4. Cook G. C., Mulligan R., Sherlock S. Controlled prospective trial of corticosteroid therapy in active chronic hepatitis. Q J Med. 1971 Apr;40(158):159–185. doi: 10.1093/oxfordjournals.qjmed.a067264. [DOI] [PubMed] [Google Scholar]
  5. Czaja A. J. Natural history, clinical features, and treatment of autoimmune hepatitis. Semin Liver Dis. 1984 Feb;4(1):1–12. doi: 10.1055/s-2008-1040641. [DOI] [PubMed] [Google Scholar]
  6. Ellis C. N., Fradin M. S., Messana J. M., Brown M. D., Siegel M. T., Hartley A. H., Rocher L. L., Wheeler S., Hamilton T. A., Parish T. G. Cyclosporine for plaque-type psoriasis. Results of a multidose, double-blind trial. N Engl J Med. 1991 Jan 31;324(5):277–284. doi: 10.1056/NEJM199101313240501. [DOI] [PubMed] [Google Scholar]
  7. Feutren G., Mihatsch M. J. Risk factors for cyclosporine-induced nephropathy in patients with autoimmune diseases. International Kidney Biopsy Registry of Cyclosporine in Autoimmune Diseases. N Engl J Med. 1992 Jun 18;326(25):1654–1660. doi: 10.1056/NEJM199206183262502. [DOI] [PubMed] [Google Scholar]
  8. Hyams J. S., Ballow M., Leichtner A. M. Cyclosporine treatment of autoimmune chronic active hepatitis. Gastroenterology. 1987 Oct;93(4):890–893. doi: 10.1016/0016-5085(87)90454-9. [DOI] [PubMed] [Google Scholar]
  9. Lawson D. H., Lovatt G. E., Gurton C. S., Hennings R. C. Adverse effects of azathioprine. Adverse Drug React Acute Poisoning Rev. 1984 Autumn;3(3):161–171. [PubMed] [Google Scholar]
  10. Masuda K., Nakajima A., Urayama A., Nakae K., Kogure M., Inaba G. Double-masked trial of cyclosporin versus colchicine and long-term open study of cyclosporin in Behçet's disease. Lancet. 1989 May 20;1(8647):1093–1096. doi: 10.1016/s0140-6736(89)92381-7. [DOI] [PubMed] [Google Scholar]
  11. Meyer zum Büschenfelde K. H., Lohse A. W., Manns M., Poralla T. Autoimmunity and liver disease. Hepatology. 1990 Aug;12(2):354–363. doi: 10.1002/hep.1840120225. [DOI] [PubMed] [Google Scholar]
  12. Mistilis S. P., Vickers C. R., Darroch M. H., McCarthy S. W. Cyclosporin, a new treatment for autoimmune chronic active hepatitis. Med J Aust. 1985 Nov 11;143(10):463–465. doi: 10.5694/j.1326-5377.1985.tb123140.x. [DOI] [PubMed] [Google Scholar]
  13. Murray-Lyon I. M., Stern R. B., Williams R. Controlled trial of prednisone and azathioprine in active chronic hepatitis. Lancet. 1973 Apr 7;1(7806):735–737. doi: 10.1016/s0140-6736(73)92125-9. [DOI] [PubMed] [Google Scholar]
  14. Myers B. D., Ross J., Newton L., Luetscher J., Perlroth M. Cyclosporine-associated chronic nephropathy. N Engl J Med. 1984 Sep 13;311(11):699–705. doi: 10.1056/NEJM198409133111103. [DOI] [PubMed] [Google Scholar]
  15. Myers B. D. What is cyclosporine nephrotoxicity? Transplant Proc. 1989 Feb;21(1 Pt 2):1430–1432. [PubMed] [Google Scholar]
  16. Page A. R., Good R. A., Pollara B. Long-term results of therapy in patients with chronic liver disease associated with hypergammaglobulinemia. Am J Med. 1969 Nov;47(5):765–774. doi: 10.1016/0002-9343(69)90169-7. [DOI] [PubMed] [Google Scholar]
  17. Schaffner F. Autoimmune chronic active hepatitis: three decades of progress. Prog Liver Dis. 1986;8:485–503. [PubMed] [Google Scholar]
  18. Shevach E. M. The effects of cyclosporin A on the immune system. Annu Rev Immunol. 1985;3:397–423. doi: 10.1146/annurev.iy.03.040185.002145. [DOI] [PubMed] [Google Scholar]
  19. Summerskill W. H., Korman M. G., Ammon H. V., Baggenstoss A. H. Prednisone for chronic active liver disease: dose titration, standard dose, and combination with azathioprine compared. Gut. 1975 Nov;16(11):876–883. doi: 10.1136/gut.16.11.876. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Tugwell P., Bombardier C., Gent M., Bennett K. J., Bensen W. G., Carette S., Chalmers A., Esdaile J. M., Klinkhoff A. V., Kraag G. R. Low-dose cyclosporin versus placebo in patients with rheumatoid arthritis. Lancet. 1990 May 5;335(8697):1051–1055. doi: 10.1016/0140-6736(90)92630-z. [DOI] [PubMed] [Google Scholar]
  21. Wright E. C., Seeff L. B., Berk P. D., Jones A., Plotz P. H. Treatment of chronic active hepatitis. An analysis of three controlled trials. Gastroenterology. 1977 Dec;73(6):1422–1430. [PubMed] [Google Scholar]

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