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Response letter to ‘role of thiopurine metabolite measurement in the management of autoimmune hepatitis’
  1. Dermot Gleeson1,
  2. Michael A Heneghan2
  1. 1Liver Unit, Sheffield Teaching Hospitals, Sheffield UK
  2. 2Institute of Liver Studies, Kings College Hospital, London, UK
  1. Correspondence to Dr Dermot Gleeson, Royal Hallamshire Hospital, Sheffield S10 2JF UK; dermot.gleeson{at}sth.nhs.uk

https://doi.org/10.1136/gutjnl-2012-302256

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    We appreciate the kind comments of Dr Al-shamma and colleagues on our guidelines.

    We agree that azathioprine (AZA) plus prednisolone is the best initial regime for autoimmune hepatitis (AIH), and like them, we would encourage perseverance with AZA in patients with minor adverse reactions, which may improve with time.

    AZA-induced hepatotoxicity in patients with inflammatory bowel disease (IBD) is usually defined as rises in serum transaminases; most cases have not had histological confirmation. We …

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    Footnotes

    • Linked article 302077.

    • Competing interests None.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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