scholarly journals Acute presentation of autoimmune hepatitis: How to find and manage still remains unsolved

2013 ◽  
Vol 43 (6) ◽  
pp. 577-579 ◽  
Author(s):  
Atsushi Tanaka
Keyword(s):  
Autoimmune Hepatitis ◽  
Acute Presentation

Mo1464 - Clinical Features of Autoimmune Hepatitis with Acute Presentation: A Japanese Nationwide Survey

2018 ◽  
Vol 154 (6) ◽  
pp. S-1215
Author(s):  
Satoru Joshita ◽  
Kaname Yoshizawa ◽  
Takeji Umemura ◽  
Hiromasa Ohira ◽  
Atsushi Takahashi ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Clinical Features ◽  
Nationwide Survey ◽  
Acute Presentation

Acute presentation and male predominance in a series of adult patients with seronegative autoimmune hepatitis

2019 ◽  
Vol 51 ◽  
pp. e20
Author(s):  
C. Bensi ◽  
C. Campani ◽  
C. Fiorini ◽  
S. Aspite ◽  
G. Vannini ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Adult Patients ◽  
Male Predominance ◽  
Acute Presentation

scholarly journals Clinical and Pathological Characteristics of Autoimmune Hepatitis with Acute Presentation

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Yi Shen ◽  
Changli Lu ◽  
Ruoting Men ◽  
Jianping Liu ◽  
Tinghong Ye ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Disease Onset ◽  
Histological Evaluation ◽  
Central Necrosis ◽  
Acute Presentation ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Lobular Inflammation

Aim. To study the differences between acute presentation-autoimmune hepatitis (A-AIH) and chronic autoimmune hepatitis (C-AIH). Methods. Through long-term follow-up, 80 patients were included in our study by using the revised international autoimmune hepatitis group (IAIHG) score and were divided into acute and chronic groups for comparison. Results. No significant difference was found in the gender, age, IAIHG score (pretreatment/posttreatment), definite diagnosis rate, extrahepatic autoimmune disease, onset time, or treatment before biopsy between the acute and chronic groups. In terms of clinical symptoms, A-AIH patients were more prone to jaundice, anorexia, yellow urine, and detesting oil than C-AIH patients, but melena only occurred in chronic group (P<0.05). The acute group exhibited more severe injury upon histological evaluation, with lobular inflammation and bile duct injury, especially central necrosis of the lobule, more pronounced in this group (P<0.05). Conclusion. A-AIH had manifestations of acute hepatitis and presented cholestasis. Serum indicators could preliminarily distinguish A-AIH and C-AIH. Histologically, the primary manifestation of A-AIH was lobular inflammation, which was usually accompanied by lobular central necrosis. For the diagnosis of A-AIH, more attention should be paid to long-term follow-up. This study was registered at ClinicalTrials.gov (identifier: NCT02994537).

Acute presentation of autoimmune hepatitis: a multicentre study with detailed histological evaluation in a large cohort of patients

2017 ◽  
Vol 70 (11) ◽  
pp. 961-969 ◽  
Author(s):  
Hiep Nguyen Canh ◽  
Kenichi Harada ◽  
Hirofumi Ouchi ◽  
Yasunori Sato ◽  
Koichi Tsuneyama ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Acute Hepatitis ◽  
Autoimmune Hepatitis ◽  
Plasma Cell ◽  
Pathological Diagnosis ◽  
Cell Infiltration ◽  
Histological Features ◽  
Acute Presentation ◽  
Necroinflammatory Activity ◽  
Plasma Cell Infiltration

AimsAlthough liver biopsy is crucial to diagnose and guide treatment decisions, a detailed histological analysis of autoimmune hepatitis (AIH) with clinically acute presentations has not yet been performed. This study aimed to characterise the histological features and explore potential histological hallmarks to diagnose the acute presentation of AIH.MethodsWe systematically evaluated liver specimens of 87 adult patients with acute presentation of AIH retrospectively enrolled from Japanese multicentre facilities. Each histological feature was predefined by consensus based on the diagnostic criteria.ResultsKey findings were that acute presentation of AIH revealed histological features of both acute hepatitis and chronic hepatitis accompanying various degrees of fibrosis. The prominent features were lobular necrosis/inflammation (97.7%), plasma cell infiltration (96.4%), emperipolesis (89.3%), pigmented macrophages (84.5%), cobblestone appearance of hepatocytes (82.6%) and perivenular necroinflammatory activity, including centrilobular necrosis (81.4%).ConclusionsThe acute presentation of AIH represents the entire histological spectrum of acute hepatitis and chronic hepatitis with various activity grades and fibrosis stages that clinically correspond to acute-onset AIH and acute exacerbation of classic AIH, respectively. Although there are no pathognomonic features for the pathological diagnosis, the prominent presence of lobular and perivenular necroinflammatory activity, pigmented macrophages and cobblestone appearance of hepatocytes in addition to the classic AIH features, such as plasma cell infiltration and emperipolesis, are useful for the pathological diagnosis of the acute presentation of AIH.

Autoimmune hepatitis with acute presentation in Japan

2010 ◽  
Vol 42 (1) ◽  
pp. 51-54 ◽  
Author(s):  
Y. Miyake ◽  
Y. Iwasaki ◽  
H. Kobashi ◽  
T. Yasunaka ◽  
F. Ikeda ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Acute Presentation

scholarly journals Clinical characteristics and treatment outcomes of acute severe autoimmune hepatitis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Linhua Zheng ◽  
Yansheng Liu ◽  
Yulong Shang ◽  
Zheyi Han ◽  
Ying Han
Keyword(s):  
Autoimmune Hepatitis ◽  
Corticosteroid Therapy ◽  
Clinical Characteristics ◽  
Antinuclear Antibodies ◽  
Therapeutic Effects ◽  
Acute Presentation ◽  
Uncommon Disease ◽  
Poor Outcomes ◽  
International Autoimmune Hepatitis Group ◽  
Smooth Muscle Antibodies

Abstract Background and aim Acute severe autoimmune hepatitis (AS-AIH) is a rare cause of acute liver failure (ALF), which is often neglected and delayed in treatment. The purpose of this study was to analyze the clinical characteristics and therapeutic effects of AS-AIH. Methods Retrospective analysis was performed. AIH was diagnosed according to the International Autoimmune Hepatitis Group (IAIHG) criteria revised in 1999. AS-AIH was defined as an acute presentation (onset of symptoms to presentation of ≤ 26 weeks) and INR of ≥ 1.5, and no histologic evidence of cirrhosis. Results Twelve patients were diagnosed as AS-AIH. At baseline, median immunoglobulin G was 28.35 g/L (range, 11.4–49.2). Ten (83.3%) patients were antinuclear antibodies and/or anti-smooth muscle antibodies positive. The prominent histologic characteristics were lobular necrosis/inflammation (91.7%) and plasma cell infiltration (100%). All patients received corticosteroid therapy. Death occurred in 2 (16.7%) patients within 30 days resulted from ALF. The average interval between the onset of symptoms and initiation of corticosteroid therapy in deceased patients was 65 days, compared with 19 days for survivors. Conclusions AS-AIH is an uncommon disease with poor outcomes. Patients with acute severe hepatitis of unknown cause should be minded the possibility of AS-AIH and corticosteroids should be considered as soon as possible.

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