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Posted 4/25/2008 6:08 PM (GMT 0)
I was reading through here and found someone who said their AIH was triggered by the drug Augmentin.  Has anyone else ever heard of this?  I was diagnosed two years ago with levels of 3245 and 2685.  I have been ok for the last year and a half.  I have a sinus infection and they put me on Augmentin again and my levels are now fluctuating.  I am trying to find out if there is solid proof that this drug causes issues with the liver. 

Thanks!

Posted 4/25/2008 7:14 PM (GMT 0)
Hello Engbunny and welcome to HealingWell,
I just googled Augmentin and liver disease and a lot of promising sites came up that may answer your question. Give it a try.


Good luck and take care...........
Posted 4/29/2008 12:04 PM (GMT 0)
Hi Engbunny and Welcome to the forum.

I too have AIH but have not heard about a specific medication interaction contributing to this disease. Although it seems logical that anything that adds to our predisposed immune systems could cause things to really kick into gear.

Lucy
Posted 4/29/2008 1:35 PM (GMT 0)
Thanks!  It is good to be here.  I am just so frustrated right now.  Things were fine for the last 18 months with no flares and now the ALT is up to 45 and here I am again on a higher dose of Prednisone and they can't tell me why it happened.  However, from everything I have read, there is no rhyme or reason as to why it happens.  I guess I thought the Cellcept and the low dose of Pred. would keep it "in remission".   However, as I keep reminding myself, it is easier to laugh than cry so hey, here I am smiling.  :-)    Does anyone else get frustrated or is it just me?
Posted 4/30/2008 3:47 AM (GMT 0)

Hi

I also have AIH, and yes it is very frustrating.  Up the meds, lower the meds, fix one thing, but cause havoc on some other body part.. its good to  have a sense of humor... I have been on pred for over a year,tried Imuran but didn't have a good reaction to it... acutally, at this point I am not even sure if it was the Imuran or the other stuff that was going on that made me feel crappy.  The pred. is no picnic......Having a liver biopsy next week, not looking forward to it..... they say 1 in 100,000 bleed to death.... I hope I am at least #2..... Switched Dr's but this one isn't looking to promising either, they all seem to have an attidude........Take care...Rhonda

Posted 4/30/2008 10:47 AM (GMT 0)
Hi Engbunny and itsme

YES I get soooooooo frustrated at times that I feel like I could have a "temper fit" just like a two year old. There are so many things that can affect liver enzyme levels that I think doctors are heisitant to guess what causes them to go up. I too take prednisone and Imuran. Have been on the pred now for two and a half years. I see my hepatologist this Friday to discuss lowering my dosage from 10mgs. Honestly it almost scares me to think what is going to happen when they start lowering the dosage, although it has played havoc with other things. I have felt almost "normal" and am hoping this will not take those feelings away.

itsme

I had a liver biopsy in January (my second so far) and honestly it was very quick with little discomfort. I know they are scary and will keep you in my thoughts. Please keep us posted on how it goes.

Lucy
Posted 4/30/2008 1:37 PM (GMT 0)

Hey Rhonda - I'll be thinking about you but if it makes you feel any better, I had two biopsies within two weeks when they were trying to diagnose me and both were ok.  There was very little discomfort.  Having to lie still for 2 horus afterward was hard for me but that is just because I have a hard time doing nothing.  :-)   Please let us know how you are doing afterward but I know it is going to be just fine. 

Hi Lucy - Ok, that makes me feel better.  I felt like I wanted to scream and kick my feet so I know exactly what you are saying.   I am 44 years old and should be past this behavior!   Therefore,  I just have smile my way through this and hopefully it will settle down.  Got it. 

I know the pred is a necessity but I have gained 40+ pounds while on it.  The dr. says that I'll always have to take it. Has anyone ever gotten off of it and not had a flare?

Posted 5/1/2008 10:19 AM (GMT 0)
Engbunny

I understand why the weight gain would be such a concern. How much are you currently taking. I know initially I gained nearly 20 lbs when I was on higher dosages, but was able to get nearly all of it off when they stablized my dose. Although it has played havoc on my taste and general eatting habits. One of the things that I have done that has helped with ever feeling of being hungry is to drink a lot of frozen slushies, I do fresh banana's and strawberries. I also drink the low sodium V-8 with a lot of ice. All of those are healthy and help trick me into feeling full, so the keep me out of the fridge.

There are several others here with AIH, although I have not heard of anyone successfully eliminating pred from their medications. I also am very curious if anyone has been able to succeed at this, partifularly since they are looking at lowering my dosage and increasing my imuran. I would like to know if this is another chaotic roller coaster ride I am about to get on.

Lucy
Posted 5/1/2008 1:03 PM (GMT 0)
Hey Lucy - Thanks for the heads up. When I was first diagnosed I was on 80mg of Solumedrol IV push for a month and then we tapered down to 5 mg of oral pred. Still, I lost the moonface but not the weight that came on with it. Now we are back up to 10 mg of pred because my ALT went up above 40. I can probably do the V-8 thing but the fruit might be tough because I am also diabetic. A lot of fruit can alter my blood sugar. Thanks for the idea
Posted 5/8/2008 10:37 PM (GMT 0)

Hi everyone.  I have not posted for quite a while.  I have been well throughout this time.  For those i haven't met i have had AIH for four years.  Originally on Pred and imuran but now 8mg Pred and CellCept.  Have been on 8mg for 10 months now.  Very frustrated that heptologist has not lowered dose despite good levels.  He's always inclined to err on the safe side and i have relapsed twice at 7.5 in the past.

A question for you.  One of my first symptoms was mouth ulcers which my GP and heptologist said were not related to AIH.  I have them again now.  Really bad ulcers on the tongue which are causing much pain and discomfort.

Has any one else suffered this?  Ithink they are sometimes called canker sore (not in australia where i am)

Take care all.
Marg


Posted 5/9/2008 12:21 AM (GMT 0)
Marg

Do you eat a lot of acidy foods like tomatoes, citrus fruits etc. My mother used to get mouth ulcers frequently when she would eat fresh grapefruits and tomatoes in season. I am sure there are probably other causes too but hers seemed to be related to diet. Hope this hleps you and so glad that you are doing so well. I see my hepatologist tomorrow and am suppose to start decreasing my pred and increasing my imuran. Not sure how I am feeling about it or if that is still the plan since they found that I have stage 1 cirrosis or not. Wish me luck.

Lucy
Posted 5/9/2008 2:22 PM (GMT 0)

Hey Marg - I didn't have any sores when I was diagnosed but I have had a couple since.  According to what I have been told, this is a virus that 90% of the human population has and when your immune system gets run down or as in our case, shut down, we are more apt to have them pop up.  Mine showed up on my lips.  There is an ointment here in the US called Abreva that really helped them heal much faster.  Also, as Lucy said, food that are high in acid can trigger them too. 

 

Posted 5/9/2008 9:47 PM (GMT 0)
Just wanted to pop in and say a quick hello to Marg. It's so good to hear the you have been doing well. Keep in touch when you can.

Take care thoughts and prayers.........
Posted 5/10/2008 10:13 PM (GMT 0)
Hi all,

I'm a new member and just came across this post. I'm currently working on a research paper on autoimmune liver diseases, and though I did not come across any specific literature on augmentin impacting LFTs, I did find the following, including studies on the affects of two other antibiotics, that may be of interest.

Researchers[14,26,31] have linked AIH to environmental factors, including a history of certain viral infections (hepatitis A or B,[14,31] measles,[14,31] and the Epstein-Barr virus[14,31]). Use of certain medications (the high blood pressure drugs methyldopa,[31] dihydralazine,[26] and tienilic acid,[26] the anti-inflammatory diclofenac,[26] the antibiotics minocycline[31] and nitrofurantoin,[31] the ananthesitc halothane,[26] and perhaps certain statins such as atorvastatin, i.e. Lipitor)[31] and herbs such as black cohosh and dai-saiko-to, may trigger autoimmune hepatitis.[14] Yet, according to Krawitt,[14] “whether drugs and herbs unmask or induce autoimmune hepatitis, or simply cause a drug-induced hepatitis with accompanying autoimmune features, is unclear.”

The number in [brackets] correspond to the following citations.
14. Krawitt EL. Autoimmune hepatitis. N Engl J Med. 2006;354(1):54-66. http://content.nejm.org/cgi/content/extract/354/1/54. Accessed January 5, 2006.
26. Obermayer-Straub P, Strassburg C, Manns M. Autoimmune hepatitis. J Hepatol. 2000;32(1 Suppl):181-197. http://www.ncbi.nlm.nih.gov/pubmed/10728804?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=5. Accessed April 23, 2008.
31. Mayo Clinic. Autoimmune hepatitis: risk factors. http://www.mayoclinic.com/health/autoimmune-hepatitis/DS00676/DSECTION=4. Accessed May 7, 2008.

Hope that helps!
Jackie
Posted 5/10/2008 10:55 PM (GMT 0)
Jackie, thanks for the input.
Posted 5/12/2008 1:47 PM (GMT 0)
Well, I am officially frustrated.  While the ALT came down to 42, the Dr. doubled my pred to try and get the number back under 40.  So, I am taking 20mg of pred a day right now.  I wish to God I knew what trigged this to start again so that I could make sure I never do it again.  They keep telling me that it isn't anything I do or eat or drink or whatever, that it is just something that happens.  *sigh* 

Sorry, I just had to blow off some steam.  It will get better.  I know it will. 

Posted 5/12/2008 3:07 PM (GMT 0)
HI Engbunny,

I'm sorry to hear about your flare and how long it's taking for your LFTs to normalize. I had a severe flare in December with LFTs in the 800s, and my LFTs six months later are just shy of normal, so I can relate to the frustration.

And I'm really sorry that you had to double Prednisone, that's just awful. Nothing like Prednisone to make you feel worse than you already do.

For me, at least, stress is a HUGE factor. Thinking back to when symptoms of your flare started, would you say that you were going through a particularly stressful time?

Jackie
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