Zouridis Spyridon, Oo Ye H, Syn Wing-Kin
Division of Gastroenterology and Hepatology, Department of Medicine, Saint Louis University Hospital, St Louis, MO.
Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
ACG Case Rep J. 2024 Jul 11;11(7):e01414. doi: 10.14309/crj.0000000000001414. eCollection 2024 Jul.
Autoimmune hepatitis (AIH) is a rare chronic liver disease affecting annually 100,000-200,000 individuals in the United States. The first-line therapy in AIH is azathioprine and corticosteroids. However, adverse events may occur, which can preclude disease remission. In these cases, mycophenolate, mercaptopurine, and tacrolimus can be used. Rituximab is offered in difficult to treat cases. Sirolimus is an alternative regimen. However, little is known about its use in AIH. This is a challenging case of "difficult to treat" AIH managed with sirolimus and rituximab, after multiple unsuccessful trials with other medications.
自身免疫性肝炎（AIH）是一种罕见的慢性肝病，在美国每年影响10万至20万人。AIH的一线治疗药物是硫唑嘌呤和皮质类固醇。然而，可能会出现不良事件，这可能会妨碍疾病缓解。在这些情况下，可以使用霉酚酸酯、巯嘌呤和他克莫司。利妥昔单抗用于治疗困难的病例。西罗莫司是一种替代方案。然而，人们对其在AIH中的应用知之甚少。这是一例具有挑战性的“难治性”AIH病例，在多次使用其他药物治疗失败后，采用西罗莫司和利妥昔单抗进行治疗。
