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Am J Gastroenterol. 2002 Dec;97(12):3160-5.

Improvement of autoimmune hepatitis during pregnancy followed by flare-up after delivery.

Author information

1
Divison of Hepatobiliary and Pancreas Diseases, University Hospital Gasthuisberg, Leuven, Belgium.

Abstract

OBJECTIVES:

Pregnancy in autoimmune hepatitis has been a rare event, but it has become more frequent with improved therapy. The present study aimed to analyze the consequences for mother and child in patients with autoimmune hepatitis.

METHODS:

Fourteen pregnancies have been followed in five patients with autoimmune chronic hepatitis (AIH) and in one with autoimmune sclerosing cholangitis (overlap AIH-PSC).

RESULTS:

Features of AIH improved markedly from the second trimester of pregnancy onward, allowing a decrease in immunosuppressive therapy. After delivery (or stillbirth in one patient), the activity of the autoimmune disease flared up rapidly in 12 of 14 events.

CONCLUSIONS:

Pregnancy induces a state of immune tolerance with improvement of the liver tests in AIH. This could result from a transition of TH1 to TH2 predominance during pregnancy. A flare-up often occurs after delivery. Preemptive increase of the immunosuppressive therapy is therefore advocated consecutive to delivery. Azathioprine use seems to be safe during pregnancy.

[Indexed for MEDLINE]

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