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Efficacy of Intravenous Glycyrrhizin in the Early Stage of Acute Onset Autoimmune Hepatitis

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Abstract

Background

Acute onset autoimmune hepatitis (AIH) shows acute presentation like acute hepatitis and does not have typical clinicopathological features of AIH. There is no gold standard for making the diagnosis. Therefore, losing the timing of starting immunosuppressive therapy, some of the cases develop into severe or fulminant form and have poor prognosis.

Aims

Our aim was to elucidate the efficacy of intravenous glycyrrhizin in decreasing alanine aminotransferase (ALT) level in the early stage of acute onset AIH.

Methods

Thirty-one patients were defined as acute onset AIH based on our uniform criteria, and were enrolled in this study. We prospectively treated 17 patients with sufficient doses (100 ml/day) of intravenous glycyrrhizin (SNMC) at an early stage (SNMC group), and treated 14 patients of severe disease with intravenous glycyrrhizin and corticosteroids (CS) (SNMC + CS group). We examined their clinical and biochemical features and treatment responses.

Results

The ALT level could be controlled at an early stage using SNMC with no significant difference compared with SNMC + CS, and responsiveness to the therapy was determined by the disease severity at the time of starting therapy rather than the time duration from onset to therapy. Recovery rate was higher in the SNMC group than in the SNMC + CS group (P = 0.035).

Conclusions

The early introduction of sufficient doses of SNMC might prevent disease progression in patients with acute onset AIH. SNMC can be used safely and be useful for patients with difficult-to-diagnose acute liver disease as an ‘initial’ treatment tool to improve liver inflammation before starting disease-specific treatments.

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Abbreviations

AIH:

Autoimmune hepatitis

SNMC:

Stronger Neo-Minophagen C

CS:

Corticosteroid

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Acknowledgments

We are indebted to all our colleagues at the liver units of our hospitals who cared for the patients described here. This study was supported in part by a Health Labour Sciences Research Grant from the Ministry of Health, Labor and Welfare of Japan as a project by the Intractable Hepato-Biliary Disease Study Group of Japan.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Shin Yasui, Keiichi Fujiwara, Akinobu Tawada, Yoshihiro Fukuda & Osamu Yokosuka

  2. Department of Pathology, Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, 276-8524, Japan

    Masayuki Nakano

Authors
  1. Shin Yasui
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  2. Keiichi Fujiwara
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  3. Akinobu Tawada
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  4. Yoshihiro Fukuda
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  5. Masayuki Nakano
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  6. Osamu Yokosuka
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Corresponding author

Correspondence to Keiichi Fujiwara.

Additional information

Shin Yasui and Keiichi Fujiwara have contributed equally to the study.

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Yasui, S., Fujiwara, K., Tawada, A. et al. Efficacy of Intravenous Glycyrrhizin in the Early Stage of Acute Onset Autoimmune Hepatitis. Dig Dis Sci 56, 3638–3647 (2011). https://doi.org/10.1007/s10620-011-1789-5

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  • DOI: https://doi.org/10.1007/s10620-011-1789-5

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