PMID- 15185304
OWN - NLM
STAT- MEDLINE
DCOM- 20040830
LR  - 20131121
IS  - 0270-9139 (Print)
IS  - 0270-9139 (Linking)
VI  - 39
IP  - 6
DP  - 2004 Jun
TI  - Progressive fibrosis during corticosteroid therapy of autoimmune hepatitis.
PG  - 1631-8
AB  - Hepatic fibrosis and cirrhosis are possible consequences of 
      corticosteroid-treated autoimmune hepatitis. Our aims were to determine the 
      frequency of progressive fibrosis and the factors associated with this 
      progression. Two hundred seventy-seven liver tissue specimens that had been 
      obtained from 73 patients were interpreted in batch under code by a single 
      pathologist. Fibrosis scores and histological activity indices were determined 
      using the Ishak scoring system, and worsening fibrosis scores were correlated 
      with clinical features, laboratory findings, and treatment responses. Fibrosis 
      scores increased (2.3 +/- 0.4 points to 4.2 +/- 0.4 points; P <.0001) in 18 
      patients (25%) during 79 +/- 13 months. Only five patients (7%) developed 
      cirrhosis, and 55 patients (75%) had stable (16 patients) or decreased (39 
      patients) fibrosis scores. Human leukocyte antigen (HLA) DR3/DR4 occurred more 
      frequently in patients with progressive fibrosis than others (23% vs. 2%; P 
      =.03). Patients with progressive fibrosis had higher histological activity 
      indices at last follow-up than patients with stable or reduced fibrosis (3.2 +/- 
      0.7 vs. 1.7 +/- 0.2; P =.01), and these indices worsened more commonly during 
      therapy (17% vs. 2%, P =.04). Relapse, treatment failure, and incomplete response 
      did not affect progression of fibrosis. In conclusion, fibrosis progresses in 
      only a minority of patients during corticosteroid therapy. Progression is 
      associated with HLA DR3/DR4 and worsening histological activity. Exacerbations or 
      persistence of disease activity does not increase disease progression after 
      treatment has been instituted.
FAU - Czaja, Albert J
AU  - Czaja AJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic and Mayo Foundation, 
      Rochester, MN, USA. czaja.albert@mayo.edu
FAU - Carpenter, Herschel A
AU  - Carpenter HA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Hepatology
JT  - Hepatology (Baltimore, Md.)
JID - 8302946
RN  - 0 (Glucocorticoids)
RN  - VB0R961HZT (Prednisone)
SB  - IM
MH  - Disease Progression
MH  - Female
MH  - Follow-Up Studies
MH  - Glucocorticoids/*adverse effects
MH  - Hepatitis, Autoimmune/*drug therapy
MH  - Humans
MH  - Liver Cirrhosis/*chemically induced/pathology
MH  - Male
MH  - Middle Aged
MH  - Prednisone/*adverse effects
MH  - Retrospective Studies
EDAT- 2004/06/09 05:00
MHDA- 2004/08/31 05:00
CRDT- 2004/06/09 05:00
PHST- 2004/06/09 05:00 [pubmed]
PHST- 2004/08/31 05:00 [medline]
PHST- 2004/06/09 05:00 [entrez]
AID - 10.1002/hep.20235 [doi]
PST - ppublish
SO  - Hepatology. 2004 Jun;39(6):1631-8. doi: 10.1002/hep.20235.