Hepatic disease autoimmune hepatitis

Hematologic diseases autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura, pernicous anemia Kidney disease Goodpasture syndrom, lipoid nephroses, minimal change glomerulonephritis Diseases of the gastrointestinal tract autoimmune chronic active hepatitis, autoimmune atrophic gastritis, Crohn s disease, ulcerative colitis... 

The distinction between primary biliary cholangitis and primary or secondary sclerosing cholangitis by differential diagnosis may be made substantially more difficult at times owing to special courses of disease, autoimmune hepatitis or overlap syndromes. 

Acebutolol Alpha-methyl-dopa Captopril Carbimazole Chlorpromazine Dihydralazine Fludarabine Hydralazine Infliximab Interferons-alpha Iproniazid Isoniazid Nomifensine Penicillamine D-Penicillamine Practolol Procainamide Propylthiouracil rlL-2 Simvastatin Tienilic acid Tryptophan contaminants Zimeldine Lupus syndrome Autoimmune haemolytic anaemia Pemphigus ANCA-associated vasculitis Lupus syndrome Autoimmune hepatitis Autoimmune haemolytic anaemia Lupus syndrome, ANCA-associated vasculitis Lupus syndrome Wide range of autoimmune diseases Autoimmune hepatitis Lupus syndrome Autoimmune haemolytic anaemia Myasthenia, dermatomyositis Anti-GBM (Goodpasture) disease Oculocutaneomucous syndrome Lupus syndrome ANCA-associated vasculitis Autoimmune thyroiditis Lupus syndrome Autoimmune hepatitis Eosinophilia myalgia syndrome (see section 9.3.5) Guillain-Barre syndrome... 

Liver disease, autoimmune. Diseases caused by autoimmune-mediated inflammation and/or fibrosis autoimmune hepatitis, -primary biliary cirrhosis, and primary sclerosing cholangitis. 

It has been well documented that the anaemia of chronic disease, ACD, results in a lowering of various haematological parameters. Several mediators are involved, among them histamine, serotonin, bradykinin, prostaglandins and, as found more recently, cytokines and nitric oxide. ACD is a parameter of systemic autoimmune disorders. The severe inflammatory stimuli lead to several systemic changes, mediated by inflammation-associated cytokines, e.g. IL-6, IL-1 TNFa, TGF beta that regulate hepatic synthesis of the acute phase proteins. 

Contraindications to treatment include autoimmune hepatitis, decompensated liver disease, women who are pregnant or patients whose female partners are pregnant, hemoglobinopathies, creatinine clearance <50 mL/ min, hemodialysis, or ischemic cardiovascular or cerebrovascular disease. 

Autoimmune diseases such as primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and autoimmune hepatitis,... 

Peginterferon alfa-2b Hypersensitivity to peginterferon alfa-2b or any component of the product autoimmune hepatitis decompensated liver disease. 

Based on the kno vledge of the processes of T cell sensitization by chemicals and the importance of T cells in induction of autoimmune diseases a number of key indicators of autoimmunogenic compounds can be defined. These include the possibility to be subject of metabolic conversion (either intra- or extra-hepatically), the capacity to activate dendritic cells, to induce cytokine production (in any cell type), or the potency to cause cell stress or cell death. Most of these processes can be studied in vitro, but none of the available methods have been tested for this purpose and often chemicals may behave completely different in vitro than in vivo. However, much can be learned from initiatives to design alternative methods for contact allergens, as many of these basic processes that lead to T cell sensitization are similar for allergenic and autoimmunogenic chemicals. 

Interferons—Family of immune system signal proteins that interfere with the ability of viruses to infect cells. Interferons have been genetically engineered to provide treatments by weakening immune response in autoimmune disease such as multiple sclerosis, or by strengthening immune response in diseases like hepatitis C. 

Immunoglobulin obtained from pooled plasma obtained from hepatitis B and HIV negative donors is used as an aspecific immunostimulant in immunodeficiency diseases, idiopathic thrombocytopenia, autoimmune hemolytic anemias, Kawasaki syndrome and to prevent infections in immune compromised patients with leukemia or multiple myeloma. Adverse effects include potentially severe hypersensitivity reactions. 

Corticosteroids, often given in conjunction with azathioprin, improve hepatic function and may reduce the risk of advancing autoimmune disease-associated cirrhosis. 

The main causes are hepatitis B and C, drug induced damage, metabolic disease (alcohol, haemochro-matosis and Wilsons disease) and autoimmune disease. Management depends upon the diagnosis. 

Autoimmune reactions associated with a-methyldopa treatment include thrombocytopenia and leukopenia. Since a few cases of an a-methyldopa-induced hepatitis have occurred, the drug is contraindicated in patients with active hepatic disease. FluUke symptoms also are known to occur. 

Interferons are contraindicated in individuals with autoimmune hepatitis or other autoimmune disease, uncontrolled thyroid disease, severe cardiac disease, severe renal or hepatic impairment, seizure disorders, and CNS dysfunction. Immunosuppressed transplant recipients should not receive interferons. Interferons should be used with caution in persons who have myelosuppression or who are taking myelosuppressive drugs. Preparations containing benzyl alcohol are associated with neurotoxicity, organ failure, and death in neonates and infants and therefore are contraindicated in this population. Interferons should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. 

Contraindications Autoimmune hepatitis, decompensated hepatic disease... 

Contraindications Autoimmune hepatitis, creatinine clearance less than 50 ml/min, hemoglobinopathies, hepatic decompensation, hypersensitivity to ribavirin products, pregnancy, significant or unstable cardiac disease... 

It is a cyclic polypeptide with 11 amino acids. It selectively inhibits T-lymphocytes proliferation, IL-2 and other cytokine production. It is the most effective drug for prevention and treatment of graft rejection reaction. It is used in cardiac, hepatic, renal, bone marrow transplantation and as second line drug in rheumatoid arthritis, inflammatory bowel disease, dermato-myositis, bronchial asthma and certain other autoimmune diseases. 

It is indicated in renal transplantation, severe active rheumatoid arthritis unresponsive to other therapy, certain autoimmune diseases, chronic active hepatitis, idiopathic thrombocytopenic purpura and acquired haemolytic anaemia. 

Contraindications to interferon alfa therapy include hepatic decompensation, autoimmune disease, and history of cardiac arrhythmia. Caution is advised in the setting of psychiatric disease, epilepsy, thyroid disease, ischemic cardiac disease, severe renal insufficiency, and cytopenia. Alfa interferons are abortifacient in primates and should not be administered in pregnancy. Potential drug-drug interactions include increased theophylline levels and increased methadone levels. Co-administration with didanosine is not recommended because of a risk of hepatic failure, and co-administration with zidovudine may exacerbate cytopenias. 

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