Question : 1. Could Imuran be the cause of minor inflammation of the liver since it is toxic to the liver? 2. Could inflammation of my liver and an elevated Igm be due to Vitamin D3 deficiency? I’ve been on Imuran since Oct 2005 after almost a year of elevated liver enzymes and without response to prednisone. I am being treated for autoimmune hepatitis with Imuran. The diagnosis has still never been made by my doctors at Mount Sinai but I am responding well to Imuran and I guess that’s evidence enough. I have had 3 biopsies (the lastest July 29, 2010) and none have confirmed the reason or causefor the hepatitis except that there is still some inflammation going on described to me as very little and the damage that I have is minimal and due to the initial trauma when I first became sick in dec 2004. It happened fast and I was very sick. I went more than a month without any treatment because a diagnosis could not be made. My alt was at 4000 before a new doctor decided to treat me with prednisone anyway. My auto antibodies ANA SMA AMA ... are always negative but my Igm continues to hover at and between 3.25 and 3.85. I have never been able to get an explanation for this while the Igg and Iga are always still normal as well. My liver enzymes have also been normal since spring 2006 while on 75-100mg of Imuran. I have never been able to take less than 75mg without my ALT going back up. Since August 2009 I began taking vitamin D supplements and after seeing a naturopath doctor started taking 5000mg D3 daily. I had my first visit at the liver clinic at Mount Sinai in March 2010 (changed doctors) and discovered my ALT was at only 10 and consistently at 10 for some time (blood work mthly). My enzymes have always been good but never this low and my Igm was now down to 2.42 very close normal 2.30. I have never seen numbers like this. I was very happy and Imuran was now being reduced to 50mg for the first time. When I informed my doctor that I was taking Vitamin D she was not pleased with the amount and said this could be toxic. I was checked and my levels were all good but I had to reduce to 2000mg a day anyway. By Oct 13, 2010 my ALT was up at 29 still normal but going up and on Nov 16 ALT was at 75. We were looking at reducing me further but instead I got a call from my doctor advising me to stay at 50mg and repeat blood work in a months’ time. I asked if this could be due to the decrease in Vitamin D, she said no, that this only means that I clearly need Imuran. At the same time I was noticing that my urine was not as clear and getting a little darker again. I just decided to start taking 5000mg of D3 again and within days to a week of doing so my urine was clear again. I also feel really good and energetic when I am on vitamin D. I am going to have bw done tomorrow and I am confident that my numbers are going to be low again. I don’t understand why this is not worth exploring when there are no other explanations for me. Thanks, Johanne YYYY@YYYY