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Gastroenterology (Expert Forum)
auto-immune colangitis
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
auto-immune colangitis
by annainitaly, Aug 30, 2004 12:00AM
I live in Italy and I am a 48 year old woman with Raynaud’s syndrome since I was 12, itching for the last 13 years, biliary stones and blood values (gGT, ALP, AST, ALT) oscillating up and down and reaching up to ten times the standard. Positive ANA >1:320; AMA 1:80; ASMA 1:40. Seven years ago a liver biopsy focused a diagnosis of auto-immune colangitis. Until recent times I’ve been treated only by acido ursodesossicolico (= ursodiol?) in increasing amounts - currently 600 mg/day. Recently I underwent a second liver biopsy to check possible progress of my disease. The response was “stadium I - II”, so my doctors chose to add prednisone (37.5 mg) and azatioprina (100 mg) to my daily treatment for a year’s time - after which they intend to assess whether the “vivacious activity” that has been recently found will have slowed down.
I am very grateful for the professional and accessible information in your site. From what I read there, it seems to me that the treatment I’ve been prescribed in Italy is similar to what I would have received overseas - is it correct? I am now accepting the fact that such an aggressive therapy is necessary, but it took me an effort to fight my long-time rejection and mistrust for drugs. Now I don’t want to be phobic, but I wonder if there are important signs of serious side effects that I should be aware of.
I would like to ask a few more questions. Is auto-immune colangitis an early stage of primary biliary cyrrhosis ? or is it a distinct kind of hepatitis ?
After having had a moderately active lifestyle, during the last years I’ve become sedentary because I get very easily exhausted, even simply on my job (I’m a teacher). Could that be a hint of chronic fatigue syndrome ? Now I’m thinking to take back some exercise (think of tai-chi), to help my bones against corticosteroids’ side effects. For the same reason I will also expose more to sunrays, which I avoided so far, due to a sensitive skin. Are there any other recommendations that you would add, to help contrast the side effects of the therapy ? Thank you very much.
I am very grateful for the professional and accessible information in your site. From what I read there, it seems to me that the treatment I’ve been prescribed in Italy is similar to what I would have received overseas - is it correct? I am now accepting the fact that such an aggressive therapy is necessary, but it took me an effort to fight my long-time rejection and mistrust for drugs. Now I don’t want to be phobic, but I wonder if there are important signs of serious side effects that I should be aware of.
I would like to ask a few more questions. Is auto-immune colangitis an early stage of primary biliary cyrrhosis ? or is it a distinct kind of hepatitis ?
After having had a moderately active lifestyle, during the last years I’ve become sedentary because I get very easily exhausted, even simply on my job (I’m a teacher). Could that be a hint of chronic fatigue syndrome ? Now I’m thinking to take back some exercise (think of tai-chi), to help my bones against corticosteroids’ side effects. For the same reason I will also expose more to sunrays, which I avoided so far, due to a sensitive skin. Are there any other recommendations that you would add, to help contrast the side effects of the therapy ? Thank you very much.
Doctor's Answer
by Kevin Pho, MD, Sep 02, 2004 12:00AM
, Sep 02, 2004 12:00AM
The combination of prednisone and azathioprine are standard and recommended treatments for autoimmune cholangitis.
Side effects of chronic prednisone use would include an increased risk of infection as well as osteoporosis amongst other things. As for azathioprine, this is also an immune suppressant and can cause some liver dysfunction as well. As long as you are being monitored by your gastroenterologist, the side effects should be manageable.
Both PBC and autoimmune hepatitis have autoimmune commonalities, and can sometimes overlap. Studies have shown that 7 percent of those with PBC also have autoimmune hepatitis.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Side effects of chronic prednisone use would include an increased risk of infection as well as osteoporosis amongst other things. As for azathioprine, this is also an immune suppressant and can cause some liver dysfunction as well. As long as you are being monitored by your gastroenterologist, the side effects should be manageable.
Both PBC and autoimmune hepatitis have autoimmune commonalities, and can sometimes overlap. Studies have shown that 7 percent of those with PBC also have autoimmune hepatitis.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
