自身免疫性肝炎疑难病例的管理
Management of Difficult Cases of Autoimmune Hepatitis.
作者信息
Lammert Craig, Loy Veronica M, Oshima Kiyoko, Gawrieh Samer
机构信息
Division of Gastroenterology and Hepatology, Indiana University School of Medicine, 702 Rotary Circle, Suite 225, Indianapolis, IN, 46202, USA.
Division of Hepatology, Loyola University, Maywood, IL, USA.
出版信息
Curr Gastroenterol Rep. 2016 Feb;18(2):9. doi: 10.1007/s11894-015-0484-7.
Abstract
Autoimmune hepatitis (AIH) is a complex autoimmune disease characterized by immune-mediated destruction of hepatic parenchyma which can result in cirrhosis, liver failure, and death. Current American Association for the Study of Liver Diseases (AASLD) and European Association for the Study of Liver (EASL) guidelines recommend corticosteroids alone or in combination with azathioprine as first-line treatment strategies. However, a significant proportion of patients may not be able to tolerate or achieve complete biochemical response with these options. In this article, we discuss approaches to these patients and other challenging AIH patient groups such as the asymptomatic, pregnant, elderly, and liver transplant recipients.
摘要
自身免疫性肝炎（AIH）是一种复杂的自身免疫性疾病，其特征是免疫介导的肝实质破坏，可导致肝硬化、肝衰竭和死亡。美国肝病研究协会（AASLD）和欧洲肝脏研究协会（EASL）目前的指南推荐单独使用皮质类固醇或与硫唑嘌呤联合作为一线治疗策略。然而，相当一部分患者可能无法耐受这些治疗方案或无法通过这些方案实现完全的生化缓解。在本文中，我们讨论针对这些患者以及其他具有挑战性的AIH患者群体（如无症状患者、孕妇、老年人和肝移植受者）的治疗方法。
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