Guidelines for therapy of autoimmune liver disease

Hiromi Ishibashi, Atsumasa Komori, Shinji Shimoda, M. Eric Gershwin

Research output: Contribution to journalArticle

42 Scopus citations

Abstract

The principle of therapy for chronic inflammatory liver diseases is the removal of causal agents. For autoimmune liver diseases, however, total removal of causal agents and immune cells is impossible. Therefore, autoimmune liver diseases are presently treated by suppression of the immune response. Autoimmune hepatitis is characteristically responsive to corticosteroids, often used in combination with azathioprine to obtain a steroidsparing effect. For primary biliary cirrhosis, ursodeoxycholic acid is safe and is the first choice for treatment. Treatment of this autoimmune liver disease should also address various symptoms and complications arising from any associated autoimmune diseases, particularly cholestasis and cirrhosis-related complications. For primary sclerosing cholangitis there are no established immunomodulatory therapies, but medical, endoscopie, and surgical treatments are applicable to this disease. Liver transplantation becomes indicated during the eventual end stages of each of these immune-mediated liver diseases.

Original languageEnglish (US)
Pages (from-to)214-226
Number of pages13
JournalSeminars in Liver Disease
Volume27
Issue number2
DOIs
StatePublished - May 2007
Externally publishedYes

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Keywords

  • Autoimmune hepatitis
  • Guideline
  • Overlapping syndrome
  • Primary biliary cirrhosis
  • Primary sclerosing cholangitis
  • Treatment

ASJC Scopus subject areas

  • Hepatology

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