CLINICAL SUBGROUP OF AUTOIMMUNE HEPATITIS TYPE-1 SUSTAINING REMISSIONWITHOUT ADDITIONAL DRUGS

BACKGROUND/AIMS: Many patients with autoimmune hepatitis type 1 need a dditional non-steroidal immunosuppressants to maintain remissions, but the indication should be limited to avoid the unnecessary side effect s. The aim of this study is to clarify the clinical subgroups of autoi mmune hepatitis type 1 sustaining remission without additional drugs. METHODOLGY: We studied 20 patients with autoimmune hepatitis type 1, i n whom complete remissions were achieved in the natural course or by p rednisolone alone. Remissions were maintained with none or less than 1 0mg/day of prednisolone.RESULTS: In the course (average: 6 years), 8 p atients (40%) remained in remission for more than three years. In the remitted group, initial values of serum gamma-globulin (p<0.05) and se rum immunoglobulin G (p<0.01) were lower than those in the relapsed gr oup. The group with less than 30 mg/ml of gamma-globulin and 3000 mg/d l of immunoglobulin G showed a significantly lower relapse rate than t he other one (p<0.01). CONCLUSIONS: There is a clinical subgroup of au toimmune hepatitis type I that sustains remission with low-dose predni solone alone. Additional immunosuppressive drugs may not be needed to maintain remissions in such patients.