Autoimmune hepatitis - primary biliary cholangitis overlap syndrome. Long-term outcomes of a retrospective cohort in a university hospital
| Autor: | Gabriel Sebastián Díaz Ramírez, Octavio Germán Muñoz Maya, Juan Ignacio Marín Zuluaga, Juan Carlos Restrepo Gutiérrez, Oscar Santos, Jorge Hernando Donado Gómez, Omar Yesid Martínez Casas |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Cirrhosis medicine.medical_treatment Autoimmune hepatitis Liver transplantation Colombia Hospitals University 03 medical and health sciences 0302 clinical medicine immune system diseases Adrenal Cortex Hormones Internal medicine medicine Long term outcomes Humans 030212 general & internal medicine Retrospective Studies business.industry Liver Cirrhosis Biliary Ursodeoxycholic Acid Autoantibody Overlap syndrome Retrospective cohort study Syndrome Middle Aged medicine.disease University hospital digestive system diseases Liver Transplantation Hepatitis Autoimmune Disease Progression 030211 gastroenterology & hepatology Female business Immunosuppressive Agents Follow-Up Studies |
| Zdroj: | Gastroenterologia y hepatologia. 41(9) |
| ISSN: | 0210-5705 |
| Popis: | Autoimmune hepatitis (AIH) with characteristics of primary biliary cholangitis (PBC) is known as overlap syndrome. Its prevalence and prognosis have not yet been determined comparatively with AIH.A retrospective cohort study was conducted comparing patients diagnosed with AIH and AIH-PBC overlap syndrome, followed-up for seven years in a university hospital in Colombia, until 31 December 2016.A total of 210 patients were included (195 women, mean age 48.5years). Of these, 32 (15.2%) had AIH-PBC overlap syndrome. At diagnosis, no significant differences were found by demographic profile, positive autoantibodies (ANA, ASMA), except AMA (81.2% vs 3.9%, P.001), and histological grade of fibrosis. The most frequent clinical presentations were nonspecific symptoms in AIH-PBC and acute hepatitis in AIH. Although there were no significant differences, AIH showed a greater biochemical response to immunosuppressive management (87.3% vs 74.2%, P=.061) and a greater number of relapses in those who achieved partial or complete remission during treatment (12.4% vs 7.63%; P=.727). Patients with AIH-PBC had greater progression to cirrhosis (22.2% vs 13.1%, P=.038), even in those who achieved partial or complete biochemical remission without relapse, with greater indication of orthotopic liver transplantation (P=.009), but not retransplantation (P=.183); there were no differences in mortality.AIH-PBC overlap syndrome accounts for a significant proportion of patients with AIH, with greater progression to cirrhosis, indication of liver transplantation and possibly retransplantation. This higher risk of adverse outcomes suggests closer monitoring, probably with follow-up until confirmed histopathological remission. |
| Databáze: | OpenAIRE |
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