PMID- 29698940
OWN - NLM
STAT- MEDLINE
DCOM- 20181120
LR  - 20191210
IS  - 1421-9867 (Electronic)
IS  - 0012-2823 (Linking)
VI  - 98
IP  - 2
DP  - 2018
TI  - Corticosteroid Therapy Improves the Outcome of Autoimmune Hepatitis-Induced Acute 
      Liver Failure.
PG  - 104-111
LID - 10.1159/000487940 [doi]
AB  - BACKGROUND/AIMS: Autoimmune hepatitis (AIH) is a relatively rare cause of liver 
      dysfunction and may lead in some cases to acute liver failure (ALF). The aim of 
      our study was to evaluate the clinical course and outcome of patients with 
      AIH-induced ALF. METHODS: We retrospectively enrolled 32 patients with 
      AIH-induced ALF and 93 age- and sex-matched patients with chronic AIH (cAIH) who 
      were enrolled at the University Clinic Essen from 1988 to 2014. All ALF patients 
      were treated with corticosteroids after diagnosis. RESULTS: Overweight, higher 
      gamma-globulin levels, the absence of anti-smooth muscle antibodies and human 
      leukocyte antigen (HLA) B8 and the presence of anti-mitochondrial antibodies and 
      HLA DR7 were risk factors for an ALF vs chronic hepatitis manifestation of AIH. 
      Liver histology was significantly more often typical for AIH in an ALF setting 
      than in cAIH. The spontaneous survival rate was 91% and 97% in ALF and cAIH 
      patients, respectively, at 6 months after diagnosis and only 1 patient in the ALF 
      group developed sepsis under therapy. CONCLUSION: Liver biopsy in an AIH-mediated 
      ALF setting was both safe and effective in diagnosing AIH. Corticosteroid therapy 
      was not associated with high mortality or sepsis. Our findings suggest that 
      corticosteroid treatment of AIH-mediated ALF may improve the outcome.
CI  - (c) 2018 S. Karger AG, Basel.
FAU - Anastasiou, Olympia E
AU  - Anastasiou OE
AD  - Department of Gastroenterology and Hepatology, University Hospital, University of 
      Duisburg Essen, Essen, Germany.
FAU - Dogan-Cavus, Betul
AU  - Dogan-Cavus B
AD  - Department of Gastroenterology and Hepatology, University Hospital, University of 
      Duisburg Essen, Essen, Germany.
FAU - Kucukoglu, Ozlem
AU  - Kucukoglu O
AD  - Department of Gastroenterology and Hepatology, University Hospital, University of 
      Magdeburg, Magdeburg, Germany.
FAU - Baba, Hideo
AU  - Baba H
AD  - Institute of Pathology, University Hospital, University of Duisburg Essen, Essen, 
      Germany.
FAU - Kahraman, Alisan
AU  - Kahraman A
AD  - Department of Gastroenterology and Hepatology, University Hospital, University of 
      Duisburg Essen, Essen, Germany.
FAU - Gerken, Guido
AU  - Gerken G
AD  - Department of Gastroenterology and Hepatology, University Hospital, University of 
      Duisburg Essen, Essen, Germany.
FAU - Schramm, Christoph
AU  - Schramm C
AD  - Department of Gastroenterology and Hepatology, University Medical Center Hamburg, 
      Hamburg, Germany.
FAU - Canbay, Ali
AU  - Canbay A
AD  - Department of Gastroenterology and Hepatology, University Hospital, University of 
      Magdeburg, Magdeburg, Germany.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20180426
PL  - Switzerland
TA  - Digestion
JT  - Digestion
JID - 0150472
RN  - 0 (Autoantibodies)
RN  - 0 (Glucocorticoids)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Autoantibodies/blood
MH  - Biopsy
MH  - Female
MH  - Glucocorticoids/*therapeutic use
MH  - Hepatitis, Autoimmune/blood/complications/*drug therapy/mortality
MH  - Humans
MH  - Liver/immunology/pathology
MH  - Liver Failure, Acute/blood/*drug therapy/etiology/mortality
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Chronic liver disease
OT  - Genotype
OT  - Human leukocyte antigen
OT  - Liver
EDAT- 2018/04/27 06:00
MHDA- 2018/11/21 06:00
CRDT- 2018/04/27 06:00
PHST- 2017/11/30 00:00 [received]
PHST- 2018/02/25 00:00 [accepted]
PHST- 2018/04/27 06:00 [pubmed]
PHST- 2018/11/21 06:00 [medline]
PHST- 2018/04/27 06:00 [entrez]
AID - 000487940 [pii]
AID - 10.1159/000487940 [doi]
PST - ppublish
SO  - Digestion. 2018;98(2):104-111. doi: 10.1159/000487940. Epub 2018 Apr 26.