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Histological improvement of liver fibrosis in well-treated patients with autoimmune hepatitis: A cohort study.

Abstract Autoimmune hepatitis (AIH) is a chronic autoimmune liver disease that if left untreated may lead to the development of cirrhosis. Previous studies on AIH patients have suggested that fibrosis and even cirrhosis can be reversed by medical treatment. The aim of this study was to evaluate the efficacy of medical treatment for protection of developing fibrosis and cirrhosis.A total of 258 liver biopsies from 101 patients (72 women, 29 men) were analyzed by a single pathologist and classified according to the Ishak grading (inflammation) and staging (fibrosis) system. Liver histology was stratified according to the temporal changes of fibrosis stage (increased, decreased, or stable), and groups were compared.Complete or partial response to medical treatment was 94.9%. Reduction of fibrosis stage from the first to the last biopsy was seen in 63 patients (62.4%). We found an association between a reduction in the fibrosis stage and continuous glucocorticoid medication, as well as lowered scores of inflammation at last biopsy. Twenty-one patients had cirrhosis (Ishak stage 6) at least in one of the previous biopsies, but only 5 patients at the last biopsy.Histological improvement is common in AIH patients that respond to medical treatment, and a reduction or stabilization of fibrosis stage occurs in about 2/3 of such patients.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28834875
OWN - NLM
STAT- MEDLINE
DA  - 20170823
DCOM- 20170911
LR  - 20170911
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 34
DP  - 2017 Aug
TI  - Histological improvement of liver fibrosis in well-treated patients with
      autoimmune hepatitis: A cohort study.
PG  - e7708
LID - 10.1097/MD.0000000000007708 [doi]
AB  - Autoimmune hepatitis (AIH) is a chronic autoimmune liver disease that if left
      untreated may lead to the development of cirrhosis. Previous studies on AIH
      patients have suggested that fibrosis and even cirrhosis can be reversed by
      medical treatment. The aim of this study was to evaluate the efficacy of medical 
      treatment for protection of developing fibrosis and cirrhosis.A total of 258
      liver biopsies from 101 patients (72 women, 29 men) were analyzed by a single
      pathologist and classified according to the Ishak grading (inflammation) and
      staging (fibrosis) system. Liver histology was stratified according to the
      temporal changes of fibrosis stage (increased, decreased, or stable), and groups 
      were compared.Complete or partial response to medical treatment was 94.9%.
      Reduction of fibrosis stage from the first to the last biopsy was seen in 63
      patients (62.4%). We found an association between a reduction in the fibrosis
      stage and continuous glucocorticoid medication, as well as lowered scores of
      inflammation at last biopsy. Twenty-one patients had cirrhosis (Ishak stage 6) at
      least in one of the previous biopsies, but only 5 patients at the last
      biopsy.Histological improvement is common in AIH patients that respond to medical
      treatment, and a reduction or stabilization of fibrosis stage occurs in about 2/3
      of such patients.
FAU - Borssen, Asa D
AU  - Borssen AD
AD  - aDepartment of Public Health and Clinical Medicine bDepartment of Medical
      Biosciences, Pathology, Umea University, Umea cDepartment of Gastroenterology and
      Hepatology, Department of Medical and Health Sciences, Linkoping University,
      Linkoping dDepartment of Molecular and Clinical Medicine, Institute of Medicine, 
      Sahlgrenska Academy, University of Gothenburg, Gothenburg eDepartment of
      Medicine, Section of Hepatology and Gastroenterology, Karolinska Institutet,
      Karolinska University Hospital Huddinge, Stockholm fDepartment of Medical
      Sciences, Section of Gastroenterology and Hepatology, Uppsala University, Uppsala
      gDivision of Infectious Diseases, Department of Medicine, Karolinska Institutet, 
      Karolinska University Hospital Huddinge, Stockholm hGastroenterology Division,
      Department of Clinical Sciences, Lund University, University Hospital Skane
      iDepartment of Gastroenterology, Faculty of Medicine and Health, Orebro
      University, Orebro, Sweden.
FAU - Palmqvist, Richard
AU  - Palmqvist R
FAU - Kechagias, Stergios
AU  - Kechagias S
FAU - Marschall, Hanns-Ulrich
AU  - Marschall HU
FAU - Bergquist, Annika
AU  - Bergquist A
FAU - Rorsman, Fredrik
AU  - Rorsman F
FAU - Weiland, Ola
AU  - Weiland O
FAU - Verbaan, Hans
AU  - Verbaan H
FAU - Nyhlin, Nils
AU  - Nyhlin N
FAU - Nilsson, Emma
AU  - Nilsson E
FAU - Werner, Marten
AU  - Werner M
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Biopsy
MH  - Child
MH  - Disease Progression
MH  - Female
MH  - Hepatitis, Autoimmune/complications/*pathology
MH  - Hospitals, University
MH  - Humans
MH  - Inflammation/etiology/*pathology
MH  - Liver Cirrhosis/etiology/*pathology
MH  - Male
MH  - Middle Aged
MH  - Severity of Illness Index
MH  - Sweden
MH  - Young Adult
PMC - PMC5571997
EDAT- 2017/08/24 06:00
MHDA- 2017/09/12 06:00
CRDT- 2017/08/24 06:00
AID - 10.1097/MD.0000000000007708 [doi]
AID - 00005792-201708250-00012 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Aug;96(34):e7708. doi: 10.1097/MD.0000000000007708.