Kim Ja Kyung
Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
Korean J Gastroenterol. 2023 Feb 25;81(2):72-85. doi: 10.4166/kjg.2023.011.
Autoimmune hepatitis (AIH) is a chronic liver disease, characterized by elevated levels of transaminases, immunoglobulin G, and positive autoantibodies. The disease course is dynamic and presents heterogeneous disease manifestations at diagnosis. This review summarizes the issues regarding the treatment and monitoring of AIH in adult patients. Glucocorticoids and azathioprine are the first line of treatment. Alternative first-line treatments include budesonide or mycophenolate mofetil (MMF). Although no randomized controlled trials have been performed, MMF, cyclosporine, tacrolimus, 6-mercaptopurine, 6-thioguanine, allopurinol, sirolimus, everolimus, infliximab, or rituximab have been attempted in patients not responding to or intolerant to first-line treatments. Most patients require life-long special monitoring, with or without maintenance treatment.
自身免疫性肝炎（AIH）是一种慢性肝病，其特征为转氨酶、免疫球蛋白G水平升高以及自身抗体呈阳性。疾病进程具有动态性，在诊断时呈现出异质性的疾病表现。本综述总结了成人自身免疫性肝炎治疗和监测方面的问题。糖皮质激素和硫唑嘌呤是一线治疗药物。替代一线治疗药物包括布地奈德或霉酚酸酯（MMF）。尽管尚未进行随机对照试验，但对于一线治疗无反应或不耐受的患者，已尝试使用MMF、环孢素、他克莫司、6-巯基嘌呤、6-硫鸟嘌呤、别嘌醇、西罗莫司、依维莫司、英夫利昔单抗或利妥昔单抗。大多数患者无论是否接受维持治疗都需要终身特殊监测。
