Analysis of clinical features and prognosis of acute severe autoimmune hepatitis

Objective: To analyze the clinical features and prognosis of acute severe autoimmune hepatitis (AIH). Methods: A retrospective analysis of the clinical data of patients with acute severe AIH admitted to our hospital from 2008 to 2019 was divided into acute AIH (A-AIH) and chronic acute AIH (AC-AIH) according to the presence or absence of liver diseases. Patients' general condition, liver biochemistry, immunology, histological features of liver, hormonal therapies prognosis and related factors were analyzed. Results: A total of 41 cases [39 females, age (54.24 ± 10.55) years] were collected. Alanine aminotransferase (ALT) and total bilirubin (TBil) were significantly increased, and the international normalized ratio (INR) was > 1.5. Acute lobular inflammation was the feature of acute and severe AIH in the histology of liver. The serum IgG level was (28.36 ± 8.35) g / L. The positive rate of antinuclear antibody (ANA) and anti-smooth muscle antibody (ASMA) was 82.9%, and 17.1%, respectively. Over 70% of acute severe AIHs were AC-AIH. The duration of onset of AC-AIH was > 8 weeks, while most A-AIHs < 8 weeks, and the differences between the two groups were statistically significant (P = 0.001). The mortality rate within 30 days after hormonal treatment was 19.5%. There were statistically significant differences in TBil, Model for End-Stage Liver Disease (MELD) score and leukocyte count between the death and survival group. Conclusion: The mortality rate in acute severe AIH is high, and most of them have the basis of chronic liver disease. Serum IgG level, autoantibodies and acute lobular inflammation are important factors for diagnosis. The prognosis of hormonal therapy is related to the patients' condition and course of disease.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:30

Enthalten in:

Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology - 30(2022), 1 vom: 20. Jan., Seite 69-73

Sprache:

Chinesisch

Beteiligte Personen:

Zheng, L H [VerfasserIn]
Shang, Y L [VerfasserIn]
Han, Z Y [VerfasserIn]
Han, Y [VerfasserIn]

Links:

Volltext

Themen:

Acute severe hepatitis
Antinuclear antibody
Autoantibodies
Autoimmune hepatitis
Centrilobular necrosis/inflammation
Corticosteroid
Journal Article

Anmerkungen:

Date Completed 15.02.2022

Date Revised 15.02.2022

published: Print

Citation Status MEDLINE

doi:

10.3760/cma.j.cn501113-20201106-00603

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM336847920