A collaborative integrative and Ayurvedic approach to cirrhosis in the setting of autoantibody negative autoimmune hepatitis: a case report

Autoimmune hepatitis (AIH) is a chronic and progressive inflammatory process of the liver, with standard treatments including prednisone, azathioprine, and ultimately liver transplant. While there are many integrative and Ayurvedic treatment options that have been shown to be helpful for other liver diseases, there are no studies that have been performed to evaluate these therapies particularly in AIH with cirrhosis. We detail the case of a 55-year-old female with cirrhosis in the setting of AIH placed on a liver transplant list after being treated with conventional therapies. She was started on various nutritional supplements and Ayurvedic treatments which resulted in a significant decrease in her Model for End-Stage Liver Disease score, which was sustained at 7 months. This is the first case report to our knowledge detailing an integrative approach to cirrhosis in the setting of AIH showing such an improvement in liver function. This paper outlines a novel approach to Autoimmune hepatitis with cirrhosis that utilizes a collaboration between Conventional, Integrative and Ayurvedic practitioners. While the basic science supports the efficacy of the individual treatments utilized in this case, there have been no published case reports outlining the safety and efficacy of these treatments when combined in a clinical setting of cirrhosis due to Autoimmune hepatitis. Thus, we set out to detail the first such case report to our knowledge of an integrative approach to cirrhosis in the setting of AIH showing such an improvement in liver function.