Document Detail


Precise histological evaluation of liver biopsy specimen is indispensable for diagnosis and treatment of acute-onset autoimmune hepatitis.
MedLine Citation:
PMID:  19107339     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The diagnosis of acute-onset autoimmune hepatitis (AIH) has been difficult because patients do not always show clinicopathological features typical of AIH. We examined the important requirements for a definitive diagnosis of acute-onset AIH. METHODS: Clinical, biochemical, and pathological features of 18 acute-onset AIH patients (16 women, 2 men; mean age, 54.3 +/- 12.3 years) with no history of liver disease and no signs of chronicity were examined. RESULTS: Mean ALT was 679 +/- 431 IU/l, and mean T-Bil was 2.4 +/- 2.9 mg/dl. Mean IgG was 1801 +/- 446 mg/dl, with 7 patients (39%) showing normal levels. Antinuclear antibody was <or=1: 40 in 7 (39%). Liver histology showed severe activity in 17 (94%) of the patients and severe acute hepatitis in 7 (39%). Centrizonal necrosis and plasma cell accumulation were characteristic for acute-onset AIH. AIH score ranged from 7 to 18 (13.2 +/- 3.8) before treatment. All patients were diagnosed and treated early and responded completely to therapy. CONCLUSIONS: Histological examination of the liver is necessary for early diagnosis of acute-onset AIH. Moreover, we should evaluate liver biopsy specimens precisely and should be ready for a timely initiation of corticosteroid therapy to improve the prognosis.
Authors:
Keiichi Fujiwara; Yoshihiro Fukuda; Osamu Yokosuka
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Publication Detail:
Type:  Journal Article     Date:  2008-12-24
Journal Detail:
Title:  Journal of gastroenterology     Volume:  43     ISSN:  0944-1174     ISO Abbreviation:  J. Gastroenterol.     Publication Date:  2008  
Date Detail:
Created Date:  2008-12-24     Completed Date:  2009-02-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9430794     Medline TA:  J Gastroenterol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  951-8     Citation Subset:  IM    
Affiliation:
Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Alanine Transaminase
Antibodies, Antinuclear / blood
Bilirubin / blood
Biopsy, Needle / methods*
Female
Hepatitis, Autoimmune / diagnosis*,  drug therapy,  pathology
Humans
Immunoglobulin G / blood
Liver / pathology*
Liver Function Tests
Male
Middle Aged
Necrosis / diagnosis
Prognosis
Chemical
Reg. No./Substance:
0/Antibodies, Antinuclear; 0/Immunoglobulin G; 635-65-4/Bilirubin; EC 2.6.1.2/Alanine Transaminase

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