Autoimmune hepatitis and overlap syndromes

Dienes, Hans Peter; Erberich, Heike; Dries, Volker; Schirmacher, Peter; Lohse, Ansgar W.

doi:10.1016/s1089-3261(02)00007-7

Cited by 52 publications

(31 citation statements)

References 44 publications

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“…Characteristic histologic features of AIH have also been well documented in the literature [19,20] . However, there is no individual histologic feature that is absolutely indicative of either DILI or AIH; thus, the evaluation of liver biopsy in determining AIH vs. DILI may be a significant challenge.…”

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confidence: 77%

Clinicopathological Study of Autoimmune Hepatitis Cases That Were Difficult to Differentiate from Drug-Induced Liver Injury

Tsutsui¹,

Harada²,

Tsuneyama³

et al. 2017

Dig Dis

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Aim: Acute-onset autoimmune hepatitis (AIH) histopathologically presents with features of acute hepatitis and lacks a specific diagnostic method. Also, AIH is often difficult to differentiate from drug-induced liver injury (DILI). We aimed to investigate the final clinical diagnosis of these cases, and compare the clinical, biochemical, and histological characteristics of AIH vs. DILI. Methods: We examined the Digestive Disease Week Japan 2004 (DDW-J) scale scores, AIH scores, clinical data, and pathological findings in 20 patients in whom it was difficult to differentiate autoimmune liver disease from DILI. Results: In cases with a DDW-J scale score of ≥5, there was a good correlation between the final diagnosis and DDW-J scale assessments, but in cases with a DDW-J scale score of ≦4 they did not correlate well. The scores for pathological findings, such as cobblestone hepatocellular change (p = 0.015), interface hepatitis (p = 0.012), and prominent plasma cells in portal areas (p = 0.011), were higher in the AIH group than in the DILI group. Conclusion: This study showed that DDW-J scale was useful for differentiating AIH from DILI in cases with a DDW-J scale score of ≧5. The histologic features of AIH were characterized by cobblestone hepatocellular change, interface hepatitis, and plasma cell infiltration of the portal region.

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confidence: 77%

Clinicopathological Study of Autoimmune Hepatitis Cases That Were Difficult to Differentiate from Drug-Induced Liver Injury

Tsutsui¹,

Harada²,

Tsuneyama³

et al. 2017

Dig Dis

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“…5 We and other investigators have earlier reported on overlap syndromes of AIH with primary biliary cirrhosis (PBC) or primary sclerosing cirrhosis (PSC) and the epidemiologic details on these overlap syndromes as well as their clinical course. [6][7][8][9] These AIH/PBC and AIH/PSC overlap syndromes are frequent and it was estimated that AIH/PBC overlap diseases may occur in their full manifestations in about 10% to 20% of cases and AIH/PSC overlap with a frequency of 2% to 8% of patients. 6 In contrast, only very limited data exist on the frequency of concurrent autoimmune diseases other than PBC or PSC in larger collectives.…”

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confidence: 99%

“…[6][7][8][9] These AIH/PBC and AIH/PSC overlap syndromes are frequent and it was estimated that AIH/PBC overlap diseases may occur in their full manifestations in about 10% to 20% of cases and AIH/PSC overlap with a frequency of 2% to 8% of patients. 6 In contrast, only very limited data exist on the frequency of concurrent autoimmune diseases other than PBC or PSC in larger collectives. The largest reported collective to be investigated for the wide variety of associated autoimmune diseases so far contained 38 patients.…”

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confidence: 99%

Concurrent Autoimmune Diseases in Patients With Autoimmune Hepatitis

Teufel

Weinmann

Kahaly

et al. 2010

Journal of Clinical Gastroenterology

187

131

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“…2). Hilfreich ist die Histologie auch in der Charakterisierung der verschiedenen Überlappungssyndrome (s. übernächste Seite) [33].…”

Section: Diagnostikunclassified

Autoimmune Lebererkrankungen: Diagnostik und Therapie

Bayer¹,

Schramm²,

Kanzler³

et al. 2004

Z Gastroenterol

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Autoimmune Hepatitis (AIH), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and overlap syndromes of these three disease entities are regarded as autoimmune liver diseases. These conditions are important differential diagnoses of elevated liver function tests as about 10 % of liver transplantations in Europe and North America are for these indications. The diagnosis is often difficult but can be facilitated by sequential measurement of relevant autoantibodies, exclusion of other liver disease, ultrasound, ERCP and liver histology. In AIH immunosuppressive therapy has been shown to prevent or stop the development of cirrhosis and improve the prognosis of the patients decisively. In other autoimmune liver diseases this evidence is missing making individual therapeutic decisions necessary. Ursodesoxycholic acid (UDCA) seems to slow disease progression in particular in early stages of PBC.

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Autoimmune hepatitis and overlap syndromes

Cited by 52 publications

References 44 publications

Clinicopathological Study of Autoimmune Hepatitis Cases That Were Difficult to Differentiate from Drug-Induced Liver Injury

Clinicopathological Study of Autoimmune Hepatitis Cases That Were Difficult to Differentiate from Drug-Induced Liver Injury

Concurrent Autoimmune Diseases in Patients With Autoimmune Hepatitis

Autoimmune Lebererkrankungen: Diagnostik und Therapie

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