International journal of clinical pharmacology and therapeutics · 2026
Evidence that mycophenolate mofetil is a safe and effective immunosuppressive in the treatment of autoimmune hepatitis and Evans syndrome: Case report.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Trad Nouha, Mensi Asma, BelHadj Mabrouk Emna, Zaimi Yosra, Ayadi Shema, Mouelhi Leila, Said Yosra, Dabbeche Radhouene
Аннотация
BACKGROUND: Autoimmune hepatitis (AIH) is a chronic immunoinflammatory liver disease frequently associated with extrahepatic autoimmune disorders. Evans syndrome (ES) is a rare chronic autoimmune condition characterized by the simultaneous presence of autoimmune hemolytic anemia and immune thrombocytopenia. Its association with AIH is uncommon, and standardized management guidelines are lacking.
CASE REPORT: We report the case of a 35-year-old patient diagnosed concurrently with type 1 AIH and ES. The initial response to oral corticosteroid therapy and azathioprine was favorable, with improvements in liver function and hematological parameters. However, during follow-up, the patient experienced multiple relapses despite receiving adequate doses of azathioprine, indicating treatment failure. Due to the unsatisfactory response to first-line therapy, mycophenolate mofetil (MMF) was initiated, resulting in sustained biochemical remission and hematological improvement with good tolerance.
CONCLUSION: MMF may be an effective and well-tolerated therapeutic option for treating type 1 AIH associated with ES. However, further studies and international collaboration are necessary to establish standardized management protocols.
CASE REPORT: We report the case of a 35-year-old patient diagnosed concurrently with type 1 AIH and ES. The initial response to oral corticosteroid therapy and azathioprine was favorable, with improvements in liver function and hematological parameters. However, during follow-up, the patient experienced multiple relapses despite receiving adequate doses of azathioprine, indicating treatment failure. Due to the unsatisfactory response to first-line therapy, mycophenolate mofetil (MMF) was initiated, resulting in sustained biochemical remission and hematological improvement with good tolerance.
CONCLUSION: MMF may be an effective and well-tolerated therapeutic option for treating type 1 AIH associated with ES. However, further studies and international collaboration are necessary to establish standardized management protocols.