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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. …