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Histological improvement of liver fibrosis in well-treated patients with autoimmune hepatitis

Danielsson Borssén, Åsa; Palmqvist, Richard; Kechagias, Stergios; Marschall, Hanns-Ulrich; Bergquist, Annika; Rorsman, Fredrik; Weiland, Ola; Verbaan, Hans LU ; Nyhlin, Nils and Nilsson, Emma LU , et al. (2017) In Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries 96(34).
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... (More)

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.

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publication status
published
subject
keywords
autoimmune hepatitis, autoimmune liver disease, cirrhosis, fibrosis, inflammation
in
Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries
volume
96
issue
34
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:85028690293
  • wos:000408504800012
ISSN
0025-7974
DOI
10.1097/MD.0000000000007708
language
English
LU publication?
yes
id
b54653b5-86e9-403c-aa49-77c1a680774d
date added to LUP
2017-10-04 15:18:52
date last changed
2018-01-16 13:20:42
@article{b54653b5-86e9-403c-aa49-77c1a680774d,
  abstract     = {<p>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.</p>},
  articleno    = {e7708},
  author       = {Danielsson Borssén, Åsa and Palmqvist, Richard and Kechagias, Stergios and Marschall, Hanns-Ulrich and Bergquist, Annika and Rorsman, Fredrik and Weiland, Ola and Verbaan, Hans and Nyhlin, Nils and Nilsson, Emma and Werner, Mårten},
  issn         = {0025-7974},
  keyword      = {autoimmune hepatitis,autoimmune liver disease,cirrhosis,fibrosis,inflammation},
  language     = {eng},
  month        = {08},
  number       = {34},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries},
  title        = {Histological improvement of liver fibrosis in well-treated patients with autoimmune hepatitis},
  url          = {http://dx.doi.org/10.1097/MD.0000000000007708},
  volume       = {96},
  year         = {2017},
}