Rare case of carotid artery occlusion due to thrombosis of a giant cerebral aneurysm: the role of cerebral revascularization.

5. Takiguchi J, Ohira H, Rai T, et al. Autoimmune hepatitis overlapping with primary sclerosing cholangitis. Intern Med 2002;41:696-700. References The presented report shows that in case of MG and collateral PSC, liver-toxic immunosuppression with AZT is tolerable and effective even over a longer period of time if the dosage is adapted according to the impaired liver functions. Low-dose AZT has a sufficient therapeutic effect on MG without deterioration of PSC. Possibly, AZT was beneficial even for PSC, since the patient exclusively required ursodesoxycholic acid, PSC did not progress so far, and AZT has also been recommended as a treatment of PSC5. Immunosuppressive agents other than AZT were considered, but they were rejected because AZT is the only approved immunosuppressive drug for MG and since other agents are potentially liver-toxic as well. Continuation of steroids was also considered since they may have a beneficial effect on PSC5 and on MG, but they were lastly stopped for their side effects, their ineffectivity on the AchR-antibody titers, and since PSC did not deteriorate after their discontinuation.