A patient with autoimmune hepatitis effectively treated with mycophenolate mofetil

Abstract

A woman in her 50s was referred to our hospital for further examination of liver dysfunction. Liver biopsy revealed interface hepatitis and plasma cell infiltration. Therefore, she was diagnosed with autoimmune hepatitis based on the diagnostic criteria. The treatment was initiated with 40 mg of prednisolone and 900 mg of ursodeoxycholic acid. However, frequent relapse occurred despite the additional administration of azathioprine. The patient eventually became steroid-dependent; therefore, prednisolone could not be reduced to <25 mg. Therefore, azathioprine was changed to mycophenolate mofetil, a second-line treatment according to the US and European guidelines. This treatment led to remission maintenance and steroid-dose reduction.

Some cases are difficult to treat with only drugs recommended by the Japanese guidelines. In such cases, mycophenolate mofetil may be a useful treatment.