Autoimmune Hepatitis Medications and Pregnancy

Question

I am a 32 year old female with autoimmune hepatitis.  For the last 6 years my doctors said it was lupus, but last fall they changed their diagnosis to AIH.  

About the time they changed the diagnosis I stopped taking plaquenil with hopes of conceiving in the spring, and stayed on prednisone only (which I've been on for the entire 6 years).  Apparently my liver does not like this approach as I have had 2 flares since October.  My doctor wants to put me on Azathioprine or Mycophenolate Mofetil in addition to the prednisone with hopes that my liver enzymes will lower and stabilize.  Currently my ALT numbers are about 3 times higher than they should be.  I am taking 15mg of prednisone now.  I was on 10mg at the start of this flare.  I have been on as little as 7mg every other day in the past.

I want to do what it takes to make myself healthy, however, I also was hoping to start a family this spring.  From what I've read about the two new drugs, neither is preferable for pregnancy.  I was wondering which of the two drugs is the lesser evil.  I also want to know if I respond to 15mg of prednisone is there any reason I can't just stay on the prednisone until after pregnancy?  Are there any other drugs I should be considering?  I'd also like to know when a safe time to try to conceive is.  

Thanks for your information.

amarie08 · Answer

I was diagnosed with AIH in 2004 just after I had my last child. I am currently on 5mg of prednisolone and 50mg of Imuran. I asked my ob/gyn and my gastro specialist about having more children and they have both assured me that it is okay while on this medication just a higher chance of miscarriage. I am now 5 weeks pregnant.

catracha80 · Answer

My name is Yolanda and I was diagnosed June 05 with AIH.  I am 27 years old and my husband and I are trying to start a family.  I started on 30 mg Prednisone and in the past 2+ years had 2 flares when the docs were trying to wean me down.  I got to 5 mg and that's when I had the last flare and they increased me to 40mg to get it under control.  I have been on 20 mg for nearly 8 months now and the doctors are not touching my dose since it seems to keep my levels normal at this rate.  Since we're trying to get pregnant they suggested  I see a high risk OB/GYN.  We did that but when I asked the questions about my meds and switching to Imuran, the doctor just read off her computer the info.   In my research and after speaking to a few hepatologist, they were ok with me staying on prednisone.  I have had many problems with the steroids, but I figure it's better than putting my "future children at risk".  If you all get some more info on these drugs and pregnancy, would you please email me at ***@****  I really would like to chat with other women in the same situation, since the OB/GYN said she had not had a patient with my diagnosis before.  SCARY HUH?  We are going on 7 months of trying, and I'm getting a little discouraged.  My doctors are very ready for me to switch to Imuran, but I have refused at this point.

pjsoni · Answer

Jennie,
I am 30 years old and have been diagnosed with AIH for approxiametly 4 years now. I am now on Imuran solely, but have taken the prednisone when I was first diagnosed. The steroids are UGLY drugs. I am wanting to begin a family as well, and have been thinking hard about turning to Holistic medicine. I was a vegetarian when I was diagnosed, but have since then changed my diet. I wanted to know if you have found any helpful information pertaining to this subject. I can't find the answers that I am looking for, nor have I even ever spoken to someone who was diagnosed with AIH. Please email me at ***@**** with any helpful information. Maybe we can be of help to one another.
Sonia

Autoimmune Hepatitis Medications and Pregnancy

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