Table 17.4.

(continued)

General manifestations	Main therapeutic modalities
Liver Primary biliary cirrhosis Autoimmune hepatitis Recognition of hepatitis C	• Ursodeoxycholic acid • Corticosteroids • Azathioprine • Aycophenolic acid
Pancreas (be aware that elevated amylase can be from glands) Sclerosing cholangitis (elevated serum levels of IgG4) Idiopathic (non-alcoholic) Pancreatitis Malabsorptive syndromes	• Corticosteroids • Ursodeoxycholic acid • Watch for strictures • Azathioprine • Mycophenolic acid • Rituximab
Kidney Interstitial nephritis Renal tubular acidosis Renal stones Glomerulonephritis Renal calculus	• Azathioprine • Mycophenolic acid • Oral potassium and sodium carbonate (3–12 g/day)
Gastrointestinal Atrophic gastritis Celiac sprue Gastroesophageal reflux Motility disorder	• Avoidance of gluten • Proton pump inhibitors • Promotility agents (Motillium, Reglan)
Accelerated atherosclerosis	Control hypertension, lipids with “tight” control
Vasculitis (cutaneous) Hyperglobulinemic purpura Mixed cryoglobulinemia Mononeuritis multiplex	Prednisolone (0.5–1.0 mg/kg body weight per day) Cyclophosphamide (0.5–1 g/m2 of body surface/month) Rituximab Plasmapheresis
Endocrine Thyroid Adrenal Blunted hypothalamic axis Iatrogenic Addisonian “Androgen Deficiency”	Thyroid replacement Corticosteroids and mineralocorticoids DHEA
Cardiac Pulmonary hypertension Pericarditis Autonomic neuropathy	Endothelin receptor antagonists Iloprost Corticosteroids Midodrine, mineralocorticoids
Gynecology–obstetric Multiple miscarriage Congenital heart block Increased HPV	Cardiolipin syndrome—lovenox Decadron Increased surveillance