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Successful rituximab therapy in refractory autoimmune hepatitis and Evan’s syndrome

Successful rituximab therapy in refractory autoimmune hepatitis and Evans syndrome.

dc.contributoren-US
dc.contributores-ES
dc.creatorCarey, Elizabeth J; Mayo Clinic Arizona
dc.creatorSomaratne, Krishni
dc.creatorRakela, Jorge
dc.date2011-10-20
dc.date.accessioned2019-11-11T18:26:33Z
dc.date.available2019-11-11T18:26:33Z
dc.identifierhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/view/1668
dc.identifier.urihttps://revistaschilenas.uchile.cl/handle/2250/110717
dc.descriptionA 44 year old woman was found to have elevated aminotransferases twice the upper limit of normal. Liver biopsy demonstrated a mixed inflammatory process suggestive of both primary biliary cirrhosis and autoimmune hepatitis (AIH).  Prednisone and azathioprine were started, with normalization of aminotransferases.  Six months later, she returned with worsening pruritus and re-evaluation demonstrated probable reactivation of AIH with acute elevation of liver injury tests. Repeat liver biopsy was suggestive of a flare of AIH which did not respond to prednisone,  azathioprine, or mycophenolate mofetil. One month later the patient was hospitalized for sudden onset of anemia and thrombocytopenia suggestive of autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura consistent with Evan’s syndrome. Rituximab was initiated and mycophenolate mofetil discontinued. After one infusion of rituximab, liver injury tests significantly improved.  Within four weeks of rituximab infusion (4 doses) the patient’s Evan’s syndrome completely resolved with normal hemoglobin and platelet levels; aminotransferases also significantly improved to less than twice the upper limit of normal.  en-US
dc.descriptionSuccessful rituximab therapy in refractory autoimmune hepatitis and Evans syndrome               A 44 year old woman was found to have elevated aminotransferases, twice the upper limit of normal. Liver biopsy demonstrated a mixed inflammatory process suggestive of both primary biliary cirrhosis and autoimmune hepatitis (AIH).  Prednisone and azathioprine were started, with normalization of aminotransferases.  Six months later, she returned with worsening pruritus and re-evaluation demonstrated probable reactivation of AIH with acute elevation of liver injury tests. Repeat liver biopsy was suggestive of a flare of AIH which did not respond to prednisone,  azathioprine, or mycophenolate mofetil. One month later the patient was hospitalized for sudden onset of anemia and thrombocytopenia, suggestive of autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura consistent with Evans syndrome. Rituximab was initiated and mycophenolate mofetil discontinued. After one infusion of rituximab, liver injury tests significantly improved.  Within four weeks of rituximab infusion (4 doses) the patient’s Evans syndrome completely resolved with normal hemoglobin and platelet levels; aminotransferases also significantly improved to less than twice the upper limit of normal. es-ES
dc.languageen
dc.publisherRevista Médica de Chilees-ES
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/1668/3414
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/1668/4015
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/1668/4040
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/1668/4041
dc.sourceRevista Médica de Chile; Vol. 139, núm. 11 (2011): NOVIEMBRE 2011es-ES
dc.source0034-9887
dc.subjectautoimmune hepatitis; monoclonal antibody; hemolytic anemia; rituximaben-US
dc.subjectAnemia, hemolytic, autoimmune; Evans syndrome; Hepatitis, autoimmune; Rituximabes-ES
dc.titleSuccessful rituximab therapy in refractory autoimmune hepatitis and Evan’s syndromeen-US
dc.titleSuccessful rituximab therapy in refractory autoimmune hepatitis and Evans syndrome.es-ES
dc.typeinfo:eu-repo/semantics/article
dc.typeinfo:eu-repo/semantics/publishedVersion
dc.typees-ES


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