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A common clinical dilemma in the management of autoimmune hepatitis (AIH) is determining which patients are candidates for complete medication withdrawal. Histologic and biochemical responses have been identified as potential predictors of successful withdrawal.
In a single-center case series of 288 patients with AIH, investigators evaluated risk for relapse of hepatitis after treatment withdrawal in 28 patients who had been in complete remission (defined as normal levels of alanine aminotransferase [ALT] and immunoglobulin G [IgG]) while on immunosuppressive monotherapy for at least 2 years. Treatments were azathioprine in 23 patients, prednisolone in 2, budesonide in 2, and 6-mercaptopurine in 1. Relapse was defined as elevated levels of A…