Histological activity despite normal ALT and IgG serum levels in patients with autoimmune hepatitis and cirrhosis
| Autor: | Gerhard Schön, Christoph Schramm, Sergio Oller-Moreno, Finn C Derben, Elmar Jaeckel, Simon Pape, Alena Laschtowitz, Munira Al Tarrah, George N. Dalekos, Richard Taubert, Till Krech, Felix Piecha, Michael A. Heneghan, Ansgar W. Lohse, Kalliopi Zachou, Sören Weidemann, Joost P.H. Drenth, Vasiliki Lygoura, Anna-Maria Liebhoff |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Alcoholic liver disease
medicine.medical_specialty NAFLD non-alcoholic fatty liver disease Cirrhosis ALD alcoholic liver disease EASL European Association for the Study of the Liver INR international normalised ratio Autoimmune hepatitis RC799-869 AST aspartate aminotransferase Biochemical remission Gastroenterology LLN lower limit of normal MELD model for end-stage liver disease Model for End-Stage Liver Disease All institutes and research themes of the Radboud University Medical Center ULN upper limit of normal immune system diseases Internal medicine ALT alanine aminotransferase TIPS transjugular intrahepatic portosystemic shunt Biopsy Internal Medicine Immunology and Allergy Medicine Hepatitis ICC intraclass correlation coefficient Hepatology medicine.diagnostic_test ALP alkaline phosphatase business.industry Histological activity AIH autoimmune hepatitis gamma-GT gamma glutamyl transferase mHAI Diseases of the digestive system. Gastroenterology Liver biopsy medicine.disease digestive system diseases TE transient elastography Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11] mHAI modified Hepatitis Activity Index business Transient elastography Research Article |
| Zdroj: | JHEP Reports JHEP Reports, Vol 3, Iss 4, Pp 100321-(2021) JHEP reports, 3 JHEP reports, 3, 4 |
| ISSN: | 2589-5559 |
| Popis: | Background & Aims In autoimmune hepatitis (AIH), normal levels of transaminases and IgG define biochemical remission and are considered the best surrogate markers for histological remission. This study assessed whether this also applies to patients with AIH cirrhosis. Methods In this European multicentric study, we included 125 biopsies from 113 patients with AIH and histologically proven cirrhosis; 105 biopsies from 104 patients with AIH without cirrhosis served as controls. Biochemical parameters were available within 4 weeks of biopsy. AIH activity was graded according to the modified Hepatitis Activity Index (mHAI), with mHAI ≥4/18 considered to indicate risk of disease progression. Results In total, 47 out of 125 liver biopsies were obtained from patients with AIH cirrhosis and normal ALT levels at time of biopsy. Only 26% (12/47) of those livers showed histological remission (mHAI Graphical abstract Highlights • A considerable proportion of patients with AIH cirrhosis show histological disease activity despite normal ALT levels. • Addition of IgG only slightly improves the prediction of low histological activity in patients with AIH and cirrhosis. • ALT and IgG do not correlate sufficiently with histological activity in AIH cirrhosis. • New surrogate markers of histological activity are needed in patients with AIH cirrhosis. |
| Databáze: | OpenAIRE |
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