Актуальные вопросы диагностики и лечения аутоиммунного гепатита (по материалам Российского консенсуса 2017 г.)

1. Ивашкин В.Т., Буеверов А.О., Маевская М.В., Абдулганиева Д.И. Клинические рекомендации по диагностике и лечению аутоиммунного гепатита. Российская Гастроэнтерологическая Ассоциация. Российское общество по изучению печени; 2013. Доступно по ссылке: http://www.gastro.ru/?pageId=41. Ссылка активна на 15.07.2017 [Ivashkin VT, Bueverov AO, Mayevskaya MV, Abdulganieva DI. Clinical recommendations for the diagnosis and treatment of autoimmune hepatitis. Russian Gastroenterological Association. Russian Society for the Study of Liver 2013. (In Russ.). Availabled at: http://www.gastro.ru/? pageId=41].
2. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Autoimmune hepatitis. J Hepatol. 2015;63:971-1004. 
doi: 10.1016/j.jhep.2015.09.016
3. Manns MP, Czaja AJ, Gorham JD, Krawitt EL, Mieli-Vergani G, Vergani D, Vierling JM. Diagnosis and Management of Autoimmune Hepatitis. AASLD Practice Guidelines. Hepatology. 2010;51(6):2193-213. doi: 10.1002/hep.23584
4. Gleeson D, Heneghan MA. British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis. Gut. 2011;60:1611-29. doi: 10.1136/gut.2010.235259
5. Буеверов А.О. Серонегативный аутоиммуный гепатит. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2017;27(2):27-33 [Buyeverov AO. Seronegative autoimmune hepatitis. Rossiiskii Zhurnal Gastroenterologii, Gepatologii, Koloproktologii. 2017;27(2):27-33 (In Russ.)]. doi: 10.22416/1382-4376-2017-27-2-27-33. 
6. Dienes HP, Erberich H, Dries V, Schirmacher P, Lohse A. Autoimmune hepatitis and overlap syndromes. Clin Liver Dis. 2002;6:349-62.
7. Czaja AJ, Carpenter HA. Autoimmune hepatitis with incidental histologic features of bile duct injury. Hepatology. 2001;34:659-65.
8. Zen Y, Notsumata K, Tanaka N, Nakanuma Y. Hepatic centrilobular zonal necrosis with positive antinuclear antibody: a unique subtype or early disease of autoimmune hepatitis? Hum Pathol. 2007;38:1669-75. 
doi: 10.1016/j.humpath.2007.03.019
9. Hofer H, Oesterreicher C, Wrba F, Ferenci P, Penner E. Centrilobular necrosis in autoimmune hepatitis: a histological feature associated with acute clinical presentation. J Clin Pathol. 2006;59:246-9. doi: 10.1136/ jcp.2005.029348
10. Loria P, Lonardo A, Leonardi F, Fontana C, Carulli L, Verrone AM, et al. Non-organ-specific autoantibodies in nonalcoholic fatty liver disease: prevalence and correlates. Dig Dis Sci. 2003;48:2173-81.
11. Cotler SJ, Kanji K, Keshavarzian A, Jensen DM, Jakate S. Prevalence and significance of autoantibodies in patients with non-alcoholic steatohepatitis. J Clin Gastroenterol. 2004;38:801-4.
12. Wiegard C, Schramm C, Lohse AW. Scoring systems for the diagnosis of autoimmune hepatitis: past, present, and future. Semin Liver Dis. 2009;29:254-61. doi: 10.1002/hep.22322
13. Luth S, Weiler-Normann C, Schramm C, Lohse AW. Autoimmune liver diseases. Internist (Berl). 2009;50:310-7. doi: 10.1007/s001
14. Verma S, Gunuwan B, Mendler M, Govindrajan S, Redeker A. Factors predicting relapse and poor outcome in type I autoimmune hepatitis: role of cirrhosis development, patterns of transaminases during remission and plasma cell activity in the liver biopsy. Am J Gastroenterol. 2004;99(8):1510-6. 
15. Luth S, Herkel J, Kanzler S, Frenzel C, Galle PR, Dienes HP, Schramm C, Lohse AW. Serologic markers compared with liver biopsy for monitoring disease activity in autoimmune hepatitis. J Clin Gastroenterol. 2008;42(8):926-30. doi: 10.1097/mcg.0b013e318154af74
16. Czaja AJ. Diagnosis and Management of Autoimmune Hepatitis: Current Status and Future Directions. Gut Liver. 2016;10(2):177-203. 
doi: 10.5009/gnl15352
17. Lohse AW, Mieli-Vergani G. Autoimmune hepatitis. J Hepatol. 2011;55(1):171-82. doi: 10.1016/j.jhep.2010.12.012
18. Feld JJ, Dinh H, Arenovich T, Marcus VA, Wanless IR, Heathcote EJ. 
Autoimmune hepatitis: effect of symptoms and cirrhosis on natural history and outcome. Hepatology. 2005;42:53-62. doi: 10.1002/hep.20732
19. Dufour JF, Zimmermann M, Reichen J. Severe autoimmune hepatitis in patients with previous spontaneous recovery of a flare. J Hepatol. 2002;37:748-52.
20. Czaja AJ. Features and consequences of untreated type 1 autoimmune hepatitis. Liver Int. 2009;29:816-23. doi: 10.1111/j.1478-3231. 2008.01904.x 
21. Kogan J, Safadi R, Ashur Y, Shouval D, Ilan Y. Prognosis of symptomatic versus asymptomatic autoimmune hepatitis: a study of 68 patients. J Clin Gastroenterol. 2002;35:75-81. 
22. Лопаткина Т.Н. Аутоиммунный гепатит и перекрестные синдромы Фарматека. 2010;15(209):62-8 [Lopatkina TN. Autoimmune hepatitis and cross-syndromes. Pharmateka. 2010;15(209):62-68 (In Russ.)].
23. Manns MP, Woynarowski M, Kreisel W, Lurie Y, Rust C, Zuckerman E, Bahr MJ, Günther R, Hultcrantz RW, Spengler U, et al. Budesonide induces remission more effectively than prednisone in a controlled trial of patients with autoimmune hepatitis. Gastroenterology. 2010; 
139:1198-206. doi: 10.1053/j.gastro.2010.06.046 
24. Woynarowski M, Nemeth A, Baruch Y, Koletzko S, Melter M, Rodeck B, Strassburg CP, Prоls M, Woźniak M, Manns MP. Budesonide versus prednisone with azathioprine for the treatment of autoimmune hepatitis 
in children and adolescents. J Pediatr. 2013;163:1347-453. 
doi: 10.1016/j.jpeds.2013.05.042 
25. Manns MP, Bahr MJ, Woynarowski M, Kreisel W, Oren R, Gunther R, Hultcrantz R, Proels M, Rust C, Spengler U, et al. Budesonide 3 mg tid is superior to prednisone in combination with azathioprine in the treatment of autoimmune hepatitis. J Hepatol. 2008;2:369. doi: 10.1016/ S0168-8278(08)60991-5 
26. Manns MP, Strassburg CP. Therapeutic strategies for autoimmune hepatitis. Dig Dis. 2011;29(4):411-5. doi: 10.1159/000329805 
27. Czaja AJ. Special clinical challenges in autoimmune hepatitis: the elderly, males, pregnancy, mild disease, fulminant onset, and nonwhite patients. Semin Liver Dis. 2009;29:315-30. doi: 10.1055/s-0029-1233530
28. Czaja AJ, Carpenter HA. Distinctive clinical phenotype and treatment outcome of type 1 autoimmune hepatitis in the elderly. Hepatology. 2006;43:532-8.
29. Czaja AJ. Clinical features, differential diagnosis and treatment of autoimmune hepatitis in the elderly. Drugs Aging. 2008;25:219-39. 
doi: 10.2165/00002512-200825030-00005  
30. Al-Chalabi T, Boccato S, Portmann BC, McFarlane IG, Heneghan MA. Autoimmune hepatitis (AIH) in the elderly: a systematic retrospective analysis of a large group of consecutive patients with definite AIH followed at a tertiary referral centre. J Hepatol. 2006;45:575-83. 
doi: 10.1016/j.jhep.2006.04.007 
31. Strassburg CP, Manns MP. Autoimmune hepatitis in the elderly: What is the difference? J Hepatol. 2006;45(4):480-2. doi: 10.1016/ j.jhep.2006.07.008  
32. Terrabuio DR, Abrantes-Lemos CP, Carrilho FJ, Cancado EL. Follow-up of pregnant women with autoimmune hepatitis: the disease behavior along with maternal and fetal outcomes. J Clin Gastroenterol. 2009;43:350-6. doi: 10.1097/MCG.0b013e318176b8c5
33. Schramm C, Herkel J, Beuers U, Kanzler S, Galle PR, Lohse AW. Pregnancy in autoimmune hepatitis: outcome and risk factors. Am J Gastroenterol. 2006;101:556-60. doi: 10.1111/j.1572-0241.2006. 00479.x 
34. Westbrook RH, Yeoman AD, Kriese S, Heneghan MA. Outcomes of pregnancy in women with autoimmune hepatitis. J Autoimmun. 2012;38:239-44. doi: 10.1016/j.jaut.2011.12.002 
35. Buchel E, van Steenbergen W, Nevens F, Fevery J. Improvement of autoimmune hepatitis during pregnancy followed by flare-up after delivery. Am J Gastroenterol. 2002;97:3160-5. doi: 10.1016/s0002-9270(02)05541-7 
36. Braga AC, Vasconcelos C, Braga J. Pregnancy with autoimmune hepatitis. Gastroenterol Hepatol Bed Bench. 2016;9(3):224. 
doi: 10.1136/bcr-2015-212501  
37. De Boer NK, Jarbandhan SV, de Graaf P, Mulder CJ, van Elburg RM, van Bodegraven AA. Azathioprine use during pregnancy: unexpected intrauterine exposure to metabolites. Am J Gastroenterol. 2006;101:1390-2. doi: 10.1111/j.1572-0241.2006.00538 
38. Hviid A, Molgaard-Nielsen D. Corticosteroid use during pregnancy and risk of orofacial clefts. Can Med Assoc J. 2011 Apr 19;183(7):796-804. doi: 10.1503/cmaj.101063 
39. Francella A, Dyan A, Bodian C, Rubin P, Chapman M, Present DH. The safety of 6-mercaptopurine for childbearing patients with inflammatory bowel disease: a retrospective cohort study. Gastroenterology. 2003;124:9-17. doi: 10.1053/gast.2003.50014  
40. Werner M, Bjоrnsson E, Prytz H. Autoimmune hepatitis among fertile women: strategies during pregnancy and breast-feeding? Scand J Gastroenterol. 2007;42:986-91. doi: 10.1080/00365520601155266  
41. Akbari M, Shah S, Velayos FS, Mahadevan U, Cheifetz AS. Systematic review and meta-analysis on the effects of thiopurines on birth outcomes from female and male patients with inflammatory bowel disease. Inflamm Bowel Dis. 2013;19:15-22. doi: 10.1002/ibd.22948
42. Casanova MJ, Chaparro M, Domеnech E. Safety of thiopurines and anti-TNF-alpha drugs during pregnancy in patients with inflammatory bowel disease. Am J Gastroenterol. 2013;108:433-40. doi: 10.1038/ajg.2012.430
43. Candia L, Marquez J, Espinoza LR. Autoimmune hepatitis and pregnancy: a rheumatologist’s dilemma. Semin Arthritis Rheum. 2005;35:49-56.
44. Bar J, Stahl B, Hod M, Wittenberg C, Pardo J, Merlob P. Is immunosuppression therapy in renal allograft recipients teratogenic? A single-center experience. Am J Med Genet A. 2003;116(1):31-6. 
doi: 10.1002/ajmg.a.10817 
45. Natekar A, Pupco A, Bosso P, Koren G. Safety of azathioprine use during pregnancy. Can Fam Phys. 2011;57(12):1401-2. 
46. Naqvi R, Noor H, Ambareen S, Khan H, Haider A, Jafri N, et al. Outcome of pregnancy in renal allograft recipients: SIUT experience. Transplant Proc. 2006;38(7):2001-2. doi: 10.1016/j.transproceed. 2006.06.020 
47. Heneghan MA, Norris SM, O’Grady JG, Harrison PM, McFarlane IG. Management and outcome of pregnancy in autoimmune hepatitis. Gut. 2001;48:97-102. 
48. Goldstein LH, Dolinsky G, Greenberg R, Schaefer C, Cohen-Kerem R, Diav-Citrin O, Malm H, Reuvers-Lodewijks ME, Rost van Tonningen-van Driel MM, Arnon J, Ornoy A, Clementi M, Di Gianantonio E, Koren G, Braunstein R, Berkovitch M. Pregnancy outcome of women exposed to azathioprine during pregnancy. Birth Defects Res A Clin Mol Teratol. 2007 Oct;79(10):696-701.
49. Hutson JR, Matlow JN, Moretti ME, Koren G. The fetal safety of thiopurines for the treatment of inflammatory bowel disease in pregnancy. J Obstet Gynaecol. 2012;33(1):1-8. doi: 10.3109/01443615. 2012.716106  

________________________________________________

1. Ivashkin VT, Bueverov AO, Mayevskaya MV, Abdulganieva DI. Clinical recommendations for the diagnosis and treatment of autoimmune hepatitis. Russian Gastroenterological Association. Russian Society for the Study of Liver 2013. (In Russ.). Availabled at: http://www.gastro.ru/? pageId=41
2. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Autoimmune hepatitis. J Hepatol. 2015;63:971-1004. 
doi: 10.1016/j.jhep.2015.09.016
3. Manns MP, Czaja AJ, Gorham JD, Krawitt EL, Mieli-Vergani G, Vergani D, Vierling JM. Diagnosis and Management of Autoimmune Hepatitis. AASLD Practice Guidelines. Hepatology. 2010;51(6):2193-213. doi: 10.1002/hep.23584
4. Gleeson D, Heneghan MA. British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis. Gut. 2011;60:1611-29. doi: 10.1136/gut.2010.235259
5. Buyeverov AO. Seronegative autoimmune hepatitis. Rossiiskii Zhurnal Gastroenterologii, Gepatologii, Koloproktologii. 2017;27(2):27-33 (In Russ.) doi: 10.22416/1382-4376-2017-27-2-27-33. 
6. Dienes HP, Erberich H, Dries V, Schirmacher P, Lohse A. Autoimmune hepatitis and overlap syndromes. Clin Liver Dis. 2002;6:349-62.
7. Czaja AJ, Carpenter HA. Autoimmune hepatitis with incidental histologic features of bile duct injury. Hepatology. 2001;34:659-65.
8. Zen Y, Notsumata K, Tanaka N, Nakanuma Y. Hepatic centrilobular zonal necrosis with positive antinuclear antibody: a unique subtype or early disease of autoimmune hepatitis? Hum Pathol. 2007;38:1669-75. 
doi: 10.1016/j.humpath.2007.03.019
9. Hofer H, Oesterreicher C, Wrba F, Ferenci P, Penner E. Centrilobular necrosis in autoimmune hepatitis: a histological feature associated with acute clinical presentation. J Clin Pathol. 2006;59:246-9. doi: 10.1136/ jcp.2005.029348
10. Loria P, Lonardo A, Leonardi F, Fontana C, Carulli L, Verrone AM, et al. Non-organ-specific autoantibodies in nonalcoholic fatty liver disease: prevalence and correlates. Dig Dis Sci. 2003;48:2173-81.
11. Cotler SJ, Kanji K, Keshavarzian A, Jensen DM, Jakate S. Prevalence and significance of autoantibodies in patients with non-alcoholic steatohepatitis. J Clin Gastroenterol. 2004;38:801-4.
12. Wiegard C, Schramm C, Lohse AW. Scoring systems for the diagnosis of autoimmune hepatitis: past, present, and future. Semin Liver Dis. 2009;29:254-61. doi: 10.1002/hep.22322
13. Luth S, Weiler-Normann C, Schramm C, Lohse AW. Autoimmune liver diseases. Internist (Berl). 2009;50:310-7. doi: 10.1007/s001
14. Verma S, Gunuwan B, Mendler M, Govindrajan S, Redeker A. Factors predicting relapse and poor outcome in type I autoimmune hepatitis: role of cirrhosis development, patterns of transaminases during remission and plasma cell activity in the liver biopsy. Am J Gastroenterol. 2004;99(8):1510-6. 
15. Luth S, Herkel J, Kanzler S, Frenzel C, Galle PR, Dienes HP, Schramm C, Lohse AW. Serologic markers compared with liver biopsy for monitoring disease activity in autoimmune hepatitis. J Clin Gastroenterol. 2008;42(8):926-30. doi: 10.1097/mcg.0b013e318154af74
16. Czaja AJ. Diagnosis and Management of Autoimmune Hepatitis: Current Status and Future Directions. Gut Liver. 2016;10(2):177-203. 
doi: 10.5009/gnl15352
17. Lohse AW, Mieli-Vergani G. Autoimmune hepatitis. J Hepatol. 2011;55(1):171-82. doi: 10.1016/j.jhep.2010.12.012
18. Feld JJ, Dinh H, Arenovich T, Marcus VA, Wanless IR, Heathcote EJ. 
Autoimmune hepatitis: effect of symptoms and cirrhosis on natural history and outcome. Hepatology. 2005;42:53-62. doi: 10.1002/hep.20732
19. Dufour JF, Zimmermann M, Reichen J. Severe autoimmune hepatitis in patients with previous spontaneous recovery of a flare. J Hepatol. 2002;37:748-52.
20. Czaja AJ. Features and consequences of untreated type 1 autoimmune hepatitis. Liver Int. 2009;29:816-23. doi: 10.1111/j.1478-3231. 2008.01904.x 
21. Kogan J, Safadi R, Ashur Y, Shouval D, Ilan Y. Prognosis of symptomatic versus asymptomatic autoimmune hepatitis: a study of 68 patients. J Clin Gastroenterol. 2002;35:75-81. 
22. Lopatkina TN. Autoimmune hepatitis and cross-syndromes. Pharmateka. 2010;15(209):62-68 (In Russ.)
23. Manns MP, Woynarowski M, Kreisel W, Lurie Y, Rust C, Zuckerman E, Bahr MJ, Günther R, Hultcrantz RW, Spengler U, et al. Budesonide induces remission more effectively than prednisone in a controlled trial of patients with autoimmune hepatitis. Gastroenterology. 2010; 
139:1198-206. doi: 10.1053/j.gastro.2010.06.046 
24. Woynarowski M, Nemeth A, Baruch Y, Koletzko S, Melter M, Rodeck B, Strassburg CP, Prоls M, Woźniak M, Manns MP. Budesonide versus prednisone with azathioprine for the treatment of autoimmune hepatitis 
in children and adolescents. J Pediatr. 2013;163:1347-453. 
doi: 10.1016/j.jpeds.2013.05.042 
25. Manns MP, Bahr MJ, Woynarowski M, Kreisel W, Oren R, Gunther R, Hultcrantz R, Proels M, Rust C, Spengler U, et al. Budesonide 3 mg tid is superior to prednisone in combination with azathioprine in the treatment of autoimmune hepatitis. J Hepatol. 2008;2:369. doi: 10.1016/ S0168-8278(08)60991-5 
26. Manns MP, Strassburg CP. Therapeutic strategies for autoimmune hepatitis. Dig Dis. 2011;29(4):411-5. doi: 10.1159/000329805 
27. Czaja AJ. Special clinical challenges in autoimmune hepatitis: the elderly, males, pregnancy, mild disease, fulminant onset, and nonwhite patients. Semin Liver Dis. 2009;29:315-30. doi: 10.1055/s-0029-1233530
28. Czaja AJ, Carpenter HA. Distinctive clinical phenotype and treatment outcome of type 1 autoimmune hepatitis in the elderly. Hepatology. 2006;43:532-8.
29. Czaja AJ. Clinical features, differential diagnosis and treatment of autoimmune hepatitis in the elderly. Drugs Aging. 2008;25:219-39. 
doi: 10.2165/00002512-200825030-00005  
30. Al-Chalabi T, Boccato S, Portmann BC, McFarlane IG, Heneghan MA. Autoimmune hepatitis (AIH) in the elderly: a systematic retrospective analysis of a large group of consecutive patients with definite AIH followed at a tertiary referral centre. J Hepatol. 2006;45:575-83. 
doi: 10.1016/j.jhep.2006.04.007 
31. Strassburg CP, Manns MP. Autoimmune hepatitis in the elderly: What is the difference? J Hepatol. 2006;45(4):480-2. doi: 10.1016/ j.jhep.2006.07.008  
32. Terrabuio DR, Abrantes-Lemos CP, Carrilho FJ, Cancado EL. Follow-up of pregnant women with autoimmune hepatitis: the disease behavior along with maternal and fetal outcomes. J Clin Gastroenterol. 2009;43:350-6. doi: 10.1097/MCG.0b013e318176b8c5
33. Schramm C, Herkel J, Beuers U, Kanzler S, Galle PR, Lohse AW. Pregnancy in autoimmune hepatitis: outcome and risk factors. Am J Gastroenterol. 2006;101:556-60. doi: 10.1111/j.1572-0241.2006. 00479.x 
34. Westbrook RH, Yeoman AD, Kriese S, Heneghan MA. Outcomes of pregnancy in women with autoimmune hepatitis. J Autoimmun. 2012;38:239-44. doi: 10.1016/j.jaut.2011.12.002 
35. Buchel E, van Steenbergen W, Nevens F, Fevery J. Improvement of autoimmune hepatitis during pregnancy followed by flare-up after delivery. Am J Gastroenterol. 2002;97:3160-5. doi: 10.1016/s0002-9270(02)05541-7 
36. Braga AC, Vasconcelos C, Braga J. Pregnancy with autoimmune hepatitis. Gastroenterol Hepatol Bed Bench. 2016;9(3):224. 
doi: 10.1136/bcr-2015-212501  
37. De Boer NK, Jarbandhan SV, de Graaf P, Mulder CJ, van Elburg RM, van Bodegraven AA. Azathioprine use during pregnancy: unexpected intrauterine exposure to metabolites. Am J Gastroenterol. 2006;101:1390-2. doi: 10.1111/j.1572-0241.2006.00538 
38. Hviid A, Molgaard-Nielsen D. Corticosteroid use during pregnancy and risk of orofacial clefts. Can Med Assoc J. 2011 Apr 19;183(7):796-804. doi: 10.1503/cmaj.101063 
39. Francella A, Dyan A, Bodian C, Rubin P, Chapman M, Present DH. The safety of 6-mercaptopurine for childbearing patients with inflammatory bowel disease: a retrospective cohort study. Gastroenterology. 2003;124:9-17. doi: 10.1053/gast.2003.50014  
40. Werner M, Bjоrnsson E, Prytz H. Autoimmune hepatitis among fertile women: strategies during pregnancy and breast-feeding? Scand J Gastroenterol. 2007;42:986-91. doi: 10.1080/00365520601155266  
41. Akbari M, Shah S, Velayos FS, Mahadevan U, Cheifetz AS. Systematic review and meta-analysis on the effects of thiopurines on birth outcomes from female and male patients with inflammatory bowel disease. Inflamm Bowel Dis. 2013;19:15-22. doi: 10.1002/ibd.22948
42. Casanova MJ, Chaparro M, Domеnech E. Safety of thiopurines and anti-TNF-alpha drugs during pregnancy in patients with inflammatory bowel disease. Am J Gastroenterol. 2013;108:433-40. doi: 10.1038/ajg.2012.430
43. Candia L, Marquez J, Espinoza LR. Autoimmune hepatitis and pregnancy: a rheumatologist’s dilemma. Semin Arthritis Rheum. 2005;35:49-56.
44. Bar J, Stahl B, Hod M, Wittenberg C, Pardo J, Merlob P. Is immunosuppression therapy in renal allograft recipients teratogenic? A single-center experience. Am J Med Genet A. 2003;116(1):31-6. 
doi: 10.1002/ajmg.a.10817 
45. Natekar A, Pupco A, Bosso P, Koren G. Safety of azathioprine use during pregnancy. Can Fam Phys. 2011;57(12):1401-2. 
46. Naqvi R, Noor H, Ambareen S, Khan H, Haider A, Jafri N, et al. Outcome of pregnancy in renal allograft recipients: SIUT experience. Transplant Proc. 2006;38(7):2001-2. doi: 10.1016/j.transproceed. 2006.06.020 
47. Heneghan MA, Norris SM, O’Grady JG, Harrison PM, McFarlane IG. Management and outcome of pregnancy in autoimmune hepatitis. Gut. 2001;48:97-102. 
48. Goldstein LH, Dolinsky G, Greenberg R, Schaefer C, Cohen-Kerem R, Diav-Citrin O, Malm H, Reuvers-Lodewijks ME, Rost van Tonningen-van Driel MM, Arnon J, Ornoy A, Clementi M, Di Gianantonio E, Koren G, Braunstein R, Berkovitch M. Pregnancy outcome of women exposed to azathioprine during pregnancy. Birth Defects Res A Clin Mol Teratol. 2007 Oct;79(10):696-701.
49. Hutson JR, Matlow JN, Moretti ME, Koren G. The fetal safety of thiopurines for the treatment of inflammatory bowel disease in pregnancy. J Obstet Gynaecol. 2012;33(1):1-8. doi: 10.3109/01443615. 2012.716106  

Е.В. Винницкая1, Ю.Г. Сандлер1, И.Г. Бакулин2, А.И. Парфенов1, Л.Ю. Ильченко3, 
И.Г. Никитин3, А.О. Буеверов4, Т.Н. Лопаткина4, Т.М. Игнатова4, В.Е. Сюткин5, 
К.Л. Райхельсон6, С.Г. Хомерики1, Р.Б. Гудкова1

1 ГБУЗ «Московский клинический научно-практический центр им. А.С. Логинова Департамента здравоохранения Москвы», Москва, Россия; 
2 ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава России, Санкт-Петербург, Россия; 
3 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия; 
4 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский университет), Москва, Россия; 
5 ГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского» Департамента здравоохранения г. Москвы, Москва, Россия; 
6 ФГБОУ ВО «Санкт-Петербургский государственный университет», Санкт-Петербург, Россия

________________________________________________

E.V. Vinnitskaya1, Yu.G. Sandler1, I.G. Bakulin2, A.I. Parfenov1, L.Yu. Ilchenko3, I.G. Nikitin3, A.O. Bueverov4, T.N. Lopatkina4, Т.М. Ignatova4, V.Ye. Syutkin5, K.L. Raikhelson6, S.G. Khomeriki1, R.B. Gudkova1

1 S.A. Loginov Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow, Russia;
2 I.I. Mechnikov North-Western state medical University, Ministry of Health of Russia, St. Petersburg, Russia;
3 N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia;
4 I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenovskiy University), Moscow, Russia; 
5 N.V. Sklifosovskiy Research Institute of Emergency Medicine, Moscow, Russia; 
6 Saint Petersburg state University, St. Petersburg, Russia