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What Precautions Should Be Taken When Diagnosed With Autoimmune Hepatitis?

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Posted on Thu, 15 Oct 2015
Question: Hello Doctor,
I have AIH and currently on AZATHIOPRINE ( 2 tablets)for months now. this was finally detected via biopsy in APRIL post all tests for types of hepatitis came negative. I am a 41 year old woman.
currently all my liver tests and complete blood count is fine. I have been advised to stay on azaron for 2 years.
I would like to know - 0ne : post withdrawal , the chances of relapse; two : survival chances; three: will azaron lead to any other disease ; and finally: precautions for me.
doctor
Answered by Dr. Naval Mendiratta (35 minutes later)
Brief Answer:
Autoimmune Hepatitis

Detailed Answer:
Good evening

Thank you for writing on health care magic

Well, Azaron is a very safe drug for autoimmune hepatitis as it can lead to complete remission and stop the further inflammation. When the tablet is started we need to monitor your Complete blood count and SGOT, SGPT initially to see if the levels are rising as it can cause some side effects in some patients as we dont monitor TPMT Levels( done in UK and US only). If the levels remain in normal limit, we can further increase it to 100 mg. So once tolerated it is a safe medicine. Only side effect is pancreatitis which is again rare

2. Once in remission, then only your doctor will withdraw the drug. To predict the relapses, is a bit hard but mostly the disease does go silent especially if your autoimmune hepatitis antibodies are negative( ANA/ASMA/Anti LKM)

3. Survival chances are good with autoimmune hepatitis if your liver parameters are good now also. People live their normal life span.

4. Precautions wise: Avoid Fatty food, avoid too much stress. Get good hours of sleep and some exercise daily.

Hope the information was useful

Do let me know for more queries

Regards
Dr Naval
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Naval Mendiratta (50 minutes later)
Thank you for your revert Doc. How will I know that my disease has gone into remission. if the liver tests are normal along with my CBC picture today, would that mean that it is under remission.
Two- What is TPMT? Can it be done in India? I am based out of XXXXXXX
Three - I only feel fatigued and confused most of the times. How many hours of sleep is advised. at present, I do manage 5-6 hours. Given an opportunity, I can sleep for hours.
I have just started to exercise but due to me being obese, it is surely uncomfortable.
rgds,
XXXX
doctor
Answered by Dr. Naval Mendiratta (8 hours later)
Brief Answer:
Autoimmune hepatitis

Detailed Answer:
Good evening XXXXXXX

Pertaining to your queries:

1. As per remission, I am not too sure why exactly the biopsy was performed when all your parameters were normal. I mean , what exactly was the indication for them performing it?If you could throw some light on it, would be helpful

2. TPMT is an enzyme which breaks down Azathioprine. So some people dont have this enzyme and can cause toxicity due to Azathioprine( rare though). It is not done in XXXXXXX They normally outsource it to UK somewhere and the cost comes around 15K and takes a lot of time( 15-20 days). So we just monitor CBC and LFT after 2 weeks before increasing Azoran

3. Well, 5- 6 hours is good and try taking a nap in the day. So it will cover up.

4. Cutting down on weight should be ur most important thing as fatty liver can even cause deranged liver function tests. SO build up on your stamina and try to reduce your weight

Hope the information was useful

Do let me know my query

Regards
Dr Naval
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 754 Questions

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What Precautions Should Be Taken When Diagnosed With Autoimmune Hepatitis?

Brief Answer: Autoimmune Hepatitis Detailed Answer: Good evening Thank you for writing on health care magic Well, Azaron is a very safe drug for autoimmune hepatitis as it can lead to complete remission and stop the further inflammation. When the tablet is started we need to monitor your Complete blood count and SGOT, SGPT initially to see if the levels are rising as it can cause some side effects in some patients as we dont monitor TPMT Levels( done in UK and US only). If the levels remain in normal limit, we can further increase it to 100 mg. So once tolerated it is a safe medicine. Only side effect is pancreatitis which is again rare 2. Once in remission, then only your doctor will withdraw the drug. To predict the relapses, is a bit hard but mostly the disease does go silent especially if your autoimmune hepatitis antibodies are negative( ANA/ASMA/Anti LKM) 3. Survival chances are good with autoimmune hepatitis if your liver parameters are good now also. People live their normal life span. 4. Precautions wise: Avoid Fatty food, avoid too much stress. Get good hours of sleep and some exercise daily. Hope the information was useful Do let me know for more queries Regards Dr Naval