Autoimmune hepatitis: Contrasts and comparisons in children and adults – A comprehensive review

Floreani, Annarosa; Liberal, Rodrigo; Vergani, Diego; Mieli‐Vergani, Giorgina

doi:10.1016/j.jaut.2013.08.004

Cited by 105 publications

(96 citation statements)

References 100 publications

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“…The autoantibody profile helps to classify AIH: in type 1, SMA and ANA are present; on type 2 anti-LKM1 antibodies are present. Type 1 AIH affects adults and children, while type 2 AIH is mainly a disease of children and adolescents [11] . The scoring system for AIH has a sensitivity of 97% to 100%.…”

Section: Minireviewsmentioning

confidence: 99%

“…Immunosuppressive treatments should be established immediately, especially in the presence of severe disease [24] . The goal of AIH treatment includes: induction of remission; maintenance of remission; prevention of the establishment of cirrhosis and complications using the lowest possible dose of medication [11,15] . AIH has a good response to immunosuppressive treatment with 80% of remission rate [15,26] .…”

Section: Pharmacologic Treatment Of Aihmentioning

confidence: 99%

“…The treatment doesn't alter the outcome in patients with decompensated liver cirrhosis on waiting list for liver transplantation or in those with cirrhosis without inflammatory activity [6] . The outcomes of therapy include: remission, relapse, treatment failure, and stabilization [11] . Normal inflammatory parameters and histology is necessary to assume remission.…”

Section: Pharmacologic Treatment Of Aihmentioning

confidence: 99%

“…Treatment should definitely be considered in any patient with proven AIH, histological activity and a more than marginal elevation of aminotransferase levels, not only in patients with levels greater 5 × ULN. In 65% to 75% of patients after 24 mo on standard therapy remission is achieved [11,27] . Relapse is defined as a flare in aminotransferase levels with symptoms under treatment, following the minimum dose of maintenance therapy, or after withdrawal.…”

Section: Pharmacologic Treatment Of Aihmentioning

confidence: 99%

“…Relapse is defined as a flare in aminotransferase levels with symptoms under treatment, following the minimum dose of maintenance therapy, or after withdrawal. Relapse occurs in about 50%; loss of remission in 42% within 6 mo of treatment withdrawal and in 80% after 3 years; progression to cirrhosis occurs in 38% and liver failure in 14% [11,17] . Retrospective analysis indicates that loss of remission or relapse occurs in virtually all patients with AIH in long-term remission when immunosuppressive therapy is discontinued [28] .…”

Section: Pharmacologic Treatment Of Aihmentioning

confidence: 99%

See 4 more Smart Citations

Management of autoimmune hepatitis: Focus on pharmacologic treatments beyond corticosteroids

Moura

Liberal

Cardoso

et al. 2014

WJH

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Core tip: With our review we pretend to describe the non-standard pharmacologic treatments available for autoimmune hepatitis, the indications for its use and the main applications. Also, we pretend to enhance that those alternatives are only available guided by the experience in liver transplant patients and should be only used by experienced centers. The difficult-totreat patients lead to the application of those therapies mainly as salvage treatments.Casal Moura M, Liberal R, Cardoso H, Horta e Vale AM, Macedo G. Management of autoimmune hepatitis: Focus on pharmacologic treatments beyond corticosteroids.

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Section: Minireviewsmentioning

confidence: 99%

Section: Pharmacologic Treatment Of Aihmentioning

confidence: 99%

Section: Pharmacologic Treatment Of Aihmentioning

confidence: 99%

Section: Pharmacologic Treatment Of Aihmentioning

confidence: 99%

Section: Pharmacologic Treatment Of Aihmentioning

confidence: 99%

See 3 more Smart Citations

Management of autoimmune hepatitis: Focus on pharmacologic treatments beyond corticosteroids

Moura

Liberal

Cardoso

et al. 2014

WJH

View full text Add to dashboard Cite

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The Liver in the Neonate, in Infancy, and Childhood

Siew

Kelly

2018

Sherlock's Diseases of the Liver and Biliary System

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Type 2 Autoimmune Hepatitis and Nonadherence to Medication Correlate With Premature Birth and Risk of Postpartum Flare

et al. 2021

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Autoimmune hepatitis (AIH) is an immune-mediated chronic liver disease that affects all ages, including women of childbearing age. Optimal management during pregnancy is poorly defined. We aimed to explore the clinical and biochemical course of AIH in the antenatal and postpartum periods, and assess factors associated with premature birth and postpartum flares. Pregnant women with AIH reviewed in the autoimmune liver disease clinic at the Queen Elizabeth Hospital Birmingham between 2009 and 2020 were identified retrospectively, and clinical, biochemical, and immunological data 1 year before conception to 1 year postpartum were collected. Analysis was performed to identify trends in blood markers over the antenatal period, with an interrupted time series approach used to assess postpartum trends. Data were available for n = 27 pregnancies (n = 20 women), with median gestation of 38 weeks (30% premature) and most having type 1 AIH (78%) and delivering via caesarean section (63%). Levels of alanine transaminase, aspartate transaminase, and immunoglobulin G all declined significantly during gestation, followed by significant stepchange increases after delivery. Postpartum flare developed in 58% of pregnancies. AIH type 2 was associated with a higher rate of premature births (67% vs. 19%, P = 0.044), and a trend toward a higher rate of postpartum flare (100% vs. 48%, P = 0.053). Although not significant, medication nonadherence was associated with almost double the risk of prematurity (40% vs. 24%, P = 0.415) and postpartum flare (80% vs. 44%, P = 0.109). Conclusion: Biochemical and immunological remission of AIH occurs during pregnancy, although subsequent postpartum flare is common. Type 2 AIH is associated with a higher risk of premature birth and postpartum flare, although further research is required to validate and explain this finding. (Hepatology Communications 2021;5:1252-1264).A utoimmune hepatitis (AIH) is a chronic, immune-mediated, progressive liver disease with variable presentation, ranging from asymptomatic to fulminant liver failure. (1) Inflammation of the hepatic parenchyma frequently evolves toward fibrosis, cirrhosis, and eventually to liver failure, exposing patients to the complications of cirrhosis and the risk of hepatocellular carcinoma. (2)

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Autoimmune hepatitis: Contrasts and comparisons in children and adults – A comprehensive review

Cited by 105 publications

References 100 publications

Management of autoimmune hepatitis: Focus on pharmacologic treatments beyond corticosteroids

Management of autoimmune hepatitis: Focus on pharmacologic treatments beyond corticosteroids

The Liver in the Neonate, in Infancy, and Childhood

Type 2 Autoimmune Hepatitis and Nonadherence to Medication Correlate With Premature Birth and Risk of Postpartum Flare

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