Autoimmune hepatitis and complexities in management

Janmohamed, Ashnila; Hirschfield, Gideon

doi:10.1136/flgastro-2018-101015

Cited by 6 publications

(2 citation statements)

References 34 publications

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“…The standard treatment approach for these patients per our unit practice is initial treatment with prednisone 20‐30 mg per day with tapering starting after 4‐8 weeks and introduction of azathioprine at 1‐2 mg/kg starting at 4 weeks. ( 31 ) Corticosteroids are generally used for at least 12‐18 months, and azathioprine (or equivalent) most frequently long term. Variations to this approach are highly individualized.…”

Section: Methodsmentioning

confidence: 99%

Multiparametric Magnetic Resonance Imaging, Autoimmune Hepatitis, and Prediction of Disease Activity

Arndtz

Shumbayawonda²,

Hodson

et al. 2021

Hepatol Commun

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Noninvasive monitoring of disease activity in autoimmune hepatitis (AIH) has potential advantages for patients for whom liver biopsy is invasive and with risk. We sought to understand the association of multiparametric magnetic resonance imaging (mpMRI) with clinical course of patients with AIH. We prospectively recruited 62 patients (median age, 55 years; 82% women) with clinically confirmed AIH. At recruitment, patients underwent mpMRI with LiverMultiScan alongside clinical investigations, which were repeated after 12‐18 months. Associations between iron‐corrected T1 (cT1) and other markers of disease were investigated at baseline and at follow‐up. Discriminative performance of cT1, liver stiffness, and enhanced liver fibrosis (ELF) to identify those who failed to maintain remission over follow‐up was investigated using the areas under the receiver operating characteristic curves (AUCs). Baseline cT1 correlated with alanine aminotransferase (Spearman’s correlation coefficient [rS] = 0.28, P = 0.028), aspartate aminotransferase (rS = 0.26, P = 0.038), international normalized ratio (rS = 0.35 P = 0.005), Model for End‐Stage Liver Disease (rS = 0.32, P = 0.020), ELF (rS = 0.29, P = 0.022), and liver stiffness rS = 0.51, P < 0.001). After excluding those not in remission at baseline (n = 12), 32% of the remainder failed to maintain remission during follow‐up. Failure to maintain remission was associated with significant increases in cT1 over follow‐up (AUC, 0.71; 95% confidence interval [CI], 0.52‐0.90; P = 0.035) but not with changes in liver stiffness (AUC, 0.68; 95% CI, 0.49‐0.87; P = 0.067) or ELF (AUC, 0.57; 95% CI, 0.37‐0.78; P = 0.502). cT1 measured at baseline was a significant predictor of future loss of biochemical remission (AUC, 0.68; 95% CI, 0.53‐0.83; P = 0.042); neither liver stiffness (AUC, 0.53; 95% CI, 0.34‐0.71; P = 0.749) nor ELF (AUC, 0.52; 95% CI, 0.33‐0.70; P = 0.843) were significant predictors of loss of biochemical remission. Conclusion: Noninvasive mpMRI has potential to contribute to risk stratification in patients with AIH.

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Section: Methodsmentioning

confidence: 99%

Multiparametric Magnetic Resonance Imaging, Autoimmune Hepatitis, and Prediction of Disease Activity

Arndtz

Shumbayawonda²,

Hodson

et al. 2021

Hepatol Commun

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“…Por otro lado, en la hepatitis autoinmune, las enfermedades autoinmunes concomitantes también son frecuentes y se estiman en alrededor del 20%, entre las que se encuentran la tiroiditis de Hashimoto, enfermedad celiaca, síndrome de Sjögren, hemólisis autoinmune, artritis reumatoide, colitis ulcerosa, psoriasis, vitíligo y púrpura trombocitopénica idiopática 6 .…”

Section: Introductionunclassified

Colitis ulcerosa cr�nica idiop�tica, la inflamaci�n m�s all� del intestino: presentaci�n de un caso cl�nico

Miranda-Cordero¹

2021

IMIDS

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Las enfermedades inflamatorias inmunomediadas (IMID, por sus siglas en inglés) son enfermedades crónicas, multifactoriales, que se caracterizan por alteraciones en la homeostasis celular. Cuando se presentan, existe un mayor riesgo de desarrollar una segunda IMID. En la enfermedad inflamatoria intestinal se estima una prevalencia del 26.6% de otras IMID. Aún no están claros los diferentes mecanismos asociados entre las diferentes IMID; sin embargo, el abordaje multidisciplinario permite un mejor control del proceso autoinmune subyacente, particularmente cuando el tratamiento impacta las vías involucradas en la fisiopatología. A continuación, se describe el caso de una mujer que presenta vitíligo, síndrome de Sjögren, artritis reumatoide y hepatitis autoinmune, complicada con colitis ulcerosa, 10 años después del inicio de la artritis reumatoide.

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Autoimmune hepatitis and complexities in management

Cited by 6 publications

References 34 publications

Multiparametric Magnetic Resonance Imaging, Autoimmune Hepatitis, and Prediction of Disease Activity

Multiparametric Magnetic Resonance Imaging, Autoimmune Hepatitis, and Prediction of Disease Activity

Colitis ulcerosa cr�nica idiop�tica, la inflamaci�n m�s all� del intestino: presentaci�n de un caso cl�nico

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