Prevalence and significance of antimitochondrial antibodies in autoimmune hepatitis (AIH) : Results from a large multicentre study of the International AIH Group
Copyright © 2023. Published by Elsevier B.V..
BACKGROUND & AIMS: Antimitochondrial antibodies (AMA) are specific markers for the diagnosis of primary biliary cholangitis (PBC) but can also be found occasionally in patients with autoimmune hepatitis (AIH). The present large multicentre cohort study assessed the prevalence and significance of AMA in AIH-patients.
METHODS: 123 AMA-positive AIH-patients were investigated and compared with 711 age-matched AMA-negative AIH-patients and 69 patients with AIH/PBC variant.
RESULTS: AMA prevalence in AIH-patients was 5.1% (range: 1.2%-11.8%). AMA-positivity was associated with female sex (p = 0.031) in AMA-positive AIH-patients but not with liver biochemistry, bile duct injury on liver biopsy, disease severity at baseline and response to treatment compared to AMA-negative AIH-patients. Comparing AMA-positive AIH-patients to those with AIH/PBC variant, there was no difference in disease severity. Regarding liver histology, AIH/PBC variant patients were characterized by the presence of at least one feature of bile duct damage (p<0.001). Response to immunosuppressive treatment was similar among groups. From AMA-positive AIH patients only those with evidence of non-specific bile duct injury had higher risk to progress to cirrhosis (HR=4.314, 95%CI: 2.348-7.928; p<0.001). During follow-up, AMA-positive AIH-patients had higher risk to develop histological bile duct injury (HR 4.654, 95%CI 1.829-11.840; p = 0.001).
CONCLUSIONS: AMA presence is relatively common among AIH-patients, but their clinical significance seems important only when they co-exist with non-specific bile duct injury at the histological level. Therefore, a careful evaluation of liver biopsy seems of utmost importance in these patients.
| Errataetall: |
CommentIn: Eur J Intern Med. 2023 Oct;116:36-37. - PMID 37558587 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:116 |
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| Enthalten in: |
European journal of internal medicine - 116(2023) vom: 09. Okt., Seite 43-50 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gatselis, Nikolaos K [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 25.10.2023 Date Revised 28.12.2023 published: Print-Electronic CommentIn: Eur J Intern Med. 2023 Oct;116:36-37. - PMID 37558587 Citation Status MEDLINE |
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| doi: |
10.1016/j.ejim.2023.06.001 |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Gatselis, Nikolaos K |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prevalence and significance of antimitochondrial antibodies in autoimmune hepatitis (AIH) |b Results from a large multicentre study of the International AIH Group |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 28.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Eur J Intern Med. 2023 Oct;116:36-37. - PMID 37558587 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023. Published by Elsevier B.V. | ||
| 520 | |a BACKGROUND & AIMS: Antimitochondrial antibodies (AMA) are specific markers for the diagnosis of primary biliary cholangitis (PBC) but can also be found occasionally in patients with autoimmune hepatitis (AIH). The present large multicentre cohort study assessed the prevalence and significance of AMA in AIH-patients | ||
| 520 | |a METHODS: 123 AMA-positive AIH-patients were investigated and compared with 711 age-matched AMA-negative AIH-patients and 69 patients with AIH/PBC variant | ||
| 520 | |a RESULTS: AMA prevalence in AIH-patients was 5.1% (range: 1.2%-11.8%). AMA-positivity was associated with female sex (p = 0.031) in AMA-positive AIH-patients but not with liver biochemistry, bile duct injury on liver biopsy, disease severity at baseline and response to treatment compared to AMA-negative AIH-patients. Comparing AMA-positive AIH-patients to those with AIH/PBC variant, there was no difference in disease severity. Regarding liver histology, AIH/PBC variant patients were characterized by the presence of at least one feature of bile duct damage (p<0.001). Response to immunosuppressive treatment was similar among groups. From AMA-positive AIH patients only those with evidence of non-specific bile duct injury had higher risk to progress to cirrhosis (HR=4.314, 95%CI: 2.348-7.928; p<0.001). During follow-up, AMA-positive AIH-patients had higher risk to develop histological bile duct injury (HR 4.654, 95%CI 1.829-11.840; p = 0.001) | ||
| 520 | |a CONCLUSIONS: AMA presence is relatively common among AIH-patients, but their clinical significance seems important only when they co-exist with non-specific bile duct injury at the histological level. Therefore, a careful evaluation of liver biopsy seems of utmost importance in these patients | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antimitochondrial antibodies | |
| 650 | 4 | |a Autoantibodies | |
| 650 | 4 | |a Autoimmune hepatitis | |
| 650 | 4 | |a Autoimmune hepatitis/primary biliary cholangitis variant syndrome | |
| 650 | 4 | |a Outcome | |
| 650 | 4 | |a Primary biliary cholangitis | |
| 650 | 7 | |a Autoantibodies |2 NLM | |
| 700 | 1 | |a Zachou, Kalliopi |e verfasserin |4 aut | |
| 700 | 1 | |a Loza, Aldo J Montano |e verfasserin |4 aut | |
| 700 | 1 | |a Cançado, Eduardo Luiz Rachid |e verfasserin |4 aut | |
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| 700 | 1 | |a Invernizzi, Pietro |e verfasserin |4 aut | |
| 700 | 1 | |a Takahashi, Athushi |e verfasserin |4 aut | |
| 700 | 1 | |a Takaki, Akinobu |e verfasserin |4 aut | |
| 700 | 1 | |a Beretta-Piccoli, Benedetta Terziroli |e verfasserin |4 aut | |
| 700 | 1 | |a van Hoek, Bart |e verfasserin |4 aut | |
| 700 | 1 | |a Lytvyak, Ellina |e verfasserin |4 aut | |
| 700 | 1 | |a Guedes, Laura Vilar |e verfasserin |4 aut | |
| 700 | 1 | |a Purnak, Tugrul |e verfasserin |4 aut | |
| 700 | 1 | |a Cazzagon, Nora |e verfasserin |4 aut | |
| 700 | 1 | |a Lygoura, Vasiliki |e verfasserin |4 aut | |
| 700 | 1 | |a Arvaniti, Pinelopi |e verfasserin |4 aut | |
| 700 | 1 | |a Rigopoulou, Eirini I |e verfasserin |4 aut | |
| 700 | 1 | |a Muratori, Luigi |e verfasserin |4 aut | |
| 700 | 1 | |a Dalekos, George N |e verfasserin |4 aut | |
| 700 | 0 | |a International Autoimmune Hepatitis Group |e verfasserin |4 aut | |
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