Reactivation of Autoimmune Hepatitis During Budesonide Monotherapy, and Response to Standard Treatment

This case study highlighted the limitations of budesonide monotherapy in treating autoimmune hepatitis (AIH) in a 22-year-old female patient. Despite initial treatment with budesonide and tapering doses of prednisolone, the patient experienced reactivation of AIH and significant steroid side effects. Transitioning to a standard treatment regimen of prednisolone and azathioprine led to rapid remission and resolution of side effects. The study suggested that budesonide might be less effective than prednisolone for inducing and maintaining remission in AIH, emphasizing the need for biopsy confirmation and azathioprine as standard treatment for AIH. The findings called for further evaluation of budesonide's role in AIH management.