Bae Sun Hwan, Kim Jae Seon, Kim Dong Hoon
Department of Pediatrics, School of Medicine, Konkuk University, Gwangjin-gu, Seoul, Korea.
J Korean Med Sci. 2006 Aug;21(4):758-60. doi: 10.3346/jkms.2006.21.4.758.
Prednisone or prednisolone are the mainstay drug treatments for autoimmune hepatitis in children. However, long-term use of corticosteroid is associated with the risk of steroid-induced toxicities, and this situation requires newer immuno-suppressive agents for the treatment of autoimmune hepatitis, especially in growing children. An 11-yr-old Korean girl with type-1 autoimmune hepatitis discontinued prednisolone due to toxicities, i.e., hirsutism, buffalo hump, and skin striae, and remained clinical and biochemical remission under replacement of deflazacort and ursodeoxycholic acid combination therapy. A follow-up liver biopsy after 19 months of deflazacort and ursodeoxycholic acid treatment showed histologic remission.
泼尼松或泼尼松龙是儿童自身免疫性肝炎的主要药物治疗手段。然而,长期使用皮质类固醇会有引发类固醇诱导毒性的风险,这种情况需要更新型的免疫抑制剂来治疗自身免疫性肝炎,尤其是对于正在成长的儿童。一名11岁患1型自身免疫性肝炎的韩国女孩因出现多毛症、水牛背和皮肤条纹等毒性反应而停用泼尼松龙,在改用去氟可特和熊去氧胆酸联合治疗后保持了临床和生化缓解状态。在接受去氟可特和熊去氧胆酸治疗19个月后的随访肝活检显示组织学缓解。