Hyams J S, Ballow M, Leichtner A M
Gastroenterology. 1987 Oct;93(4):890-3. doi: 10.1016/0016-5085(87)90454-9.
A 14-yr-old boy with a 5-yr history of autoimmune chronic active hepatitis refractory to corticosteroid therapy was given cyclosporin A (5 mg/kg X day). Before cyclosporine therapy, serum aminotransferase levels were 20 times normal and immunoglobulin G was 4 g/dl. Within 2 wk of starting cyclosporine therapy, aminotransferase levels decreased; by 2 mo they were almost normal, and at 1 yr into therapy they were normal. A decrease in cyclosporine dosage was associated with an increase in aminotransferase levels, which then again decreased as the dose was increased. Severe growth failure observed during previous corticosteroid therapy reversed during cyclosporine treatment and the patient displayed "catch-up" growth. No significant side effects were noted after 1 yr of cyclosporine therapy. Further evaluation of cyclosporine in the treatment of corticosteroid-unresponsive autoimmune chronic active hepatitis appears warranted.
一名患有自身免疫性慢性活动性肝炎5年的14岁男孩，对皮质类固醇治疗无效，给予环孢素A（5毫克/千克×天）。在环孢素治疗前，血清转氨酶水平是正常的20倍，免疫球蛋白G为4克/分升。开始环孢素治疗后2周内，转氨酶水平下降；到2个月时几乎正常，治疗1年后恢复正常。环孢素剂量减少与转氨酶水平升高有关，而随着剂量增加转氨酶水平又再次下降。在先前皮质类固醇治疗期间观察到的严重生长发育迟缓在环孢素治疗期间得到逆转，患者出现“追赶”生长。环孢素治疗1年后未发现明显副作用。进一步评估环孢素在治疗对皮质类固醇无反应的自身免疫性慢性活动性肝炎中的作用似乎是有必要的。
