eISSN: 2449-8238
ISSN: 2392-1099
Clinical and Experimental Hepatology
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vol. 9
Original paper

The relationship between 6-thioguanine levels and remission outcomes in children with autoimmune hepatitis. Single center experience

Dominika Kaps-Kopiec
Agnieszka Czajkowska
Marta Górska
Małgorzata Woźniak
Dorota Jarzębicka
Joanna Cielecka-Kuszyk
Piotr Czubkowski
Joanna Pawłowska

Department of Gastroenterology, Hepatology, Nutritional Disorders and Pediatrics, Children’s Memorial Health Institute, Warsaw, Poland
Department of Biochemistry, Radioimmunology and Experimental Medicine, Children’s Memorial Health Institute, Warsaw, Poland
Department of Pathology, Children’s Memorial Health Institute, Warsaw, Poland
Clin Exp HEPATOL 2023; 9, 2: 115-121
Online publish date: 2023/06/26
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Aim of the study:
The treatment of autoimmune hepatitis (AIH) is based on steroids and azathioprine (AZA). AZA is a pro-drug which is converted among others into 6-thioguanine (6-TG) and 6-methylmercaptopurine (6-MMP). The aim of the study was to determine the relationship between the AZA active metabolite 6-TG and both the biochemical and histological remission outcomes.

Material and methods:
The authors conducted a retrospective analysis of a single chart review. The sample size consisted of 44 pediatric patients with AIH. Biochemical remission was defined as an alanine aminotransferase (ALT) level below 40 U/l and histological remission was defined as a situation when the control biopsy revealed inflammation grade G1 (or lower) in the Batts-Ludwig score. Statistical analysis was applied to assess the difference in remission outcomes in patients with different levels of 6-TG.

In the benchmark variant of our statistical analysis, we found that the correlation between 6-TG and ALT in the sample was not statistically significant. Moreover, the difference between the mean levels of ALT in the populations in and without remission was not statistically significant (the p-value of the t-test was 0.16).

Our results tend to support the claim that there is no statistically significant relationship between 6-TG concentration and remission (both biochemical and histological) in pediatric patients with AIH.


children, treatment, autoimmune hepatitis, remission, 6-thioguanine levels

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