Comparison of clinical features and liver histology in acute and chronic autoimmune hepatitis

Iwai, Masaki; Jo, Masayasu; Ishii, Michiaki; Mori, Takahiro; Harada, Yoshinori

doi:10.1111/j.1872-034x.2008.00347.x

Cited by 35 publications

(38 citation statements)

References 20 publications

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“…Compared with other histological features reported previously, the present data show both similarities and broad differences as follows (our data vs other studies): hepatic rosette formation (60.5% vs 14.6–55.6%),22 24 27 34 35 58 interface hepatitis (75% vs 66.7–92.3%),5 22 35 36 42 58 bile duct injury (50% vs 21.1–77.8%),22 58 fibrosis (67.4% vs 40–96.1%),5 6 16 22 34 36 42 67 end-stage fibrosis (stage 4) (0% vs 0–33.3%),5–7 14 16 42 portal inflammation (92.9% vs 90–100%),16 22 35 lobular necrosis/inflammation (97.7% vs 73–100%)5 16 22 27 42 67 and cobblestone appearance of hepatocytes (82.6% vs 44.4%, 8/18 cases) 27. It is worth noting that the frequencies of fibrosis and interface hepatitis varied markedly among studies, which may have led to controversial conclusions in the clinicopathological characteristics of AIH with acute presentations compared with classic AIH.…”

Section: Discussionsupporting

confidence: 73%

Acute presentation of autoimmune hepatitis: a multicentre study with detailed histological evaluation in a large cohort of patients

et al. 2017

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The acute presentation of AIH represents the entire histological spectrum of acute hepatitis and chronic hepatitis with various activity grades and fibrosis stages that clinically correspond to acute-onset AIH and acute exacerbation of classic AIH, respectively. Although there are no pathognomonic features for the pathological diagnosis, the prominent presence of lobular and perivenular necroinflammatory activity, pigmented macrophages and cobblestone appearance of hepatocytes in addition to the classic AIH features, such as plasma cell infiltration and emperipolesis, are useful for the pathological diagnosis of the acute presentation of AIH.

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Section: Discussionsupporting

confidence: 73%

Acute presentation of autoimmune hepatitis: a multicentre study with detailed histological evaluation in a large cohort of patients

et al. 2017

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“…When AIH presents as acute hepatitis the liver histology may be atypical: lobular hepatitis and centrilobular necrosis are common and cirrhosis less common 66 67 75. Furthermore, serum autoantibodies are sometimes absent initially but develop later.…”

Section: B Presentation and Diagnosismentioning

confidence: 99%

British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis

Gleeson

Heneghan

2011

Gut

246

336

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Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease which, if untreated, often leads to cirrhosis, liver failure and death. Major advances were made in its management based on controlled trials performed in England and the USA in the 1970s and 1980s. Unfortunately, in recent decades there has been a dearth of controlled clinical trials and, thus, many questions regarding the optimal management of this disease remain unanswered. Many promising newer immunosuppressive therapies await formal comparison with standard therapies and also many important details in relation to the application of standard therapies remain unclear. These guidelines describe the optimal management strategies in adults based on available published evidence, including the American Association for the Study of Liver Diseases practice guidelines for the diagnosis and treatment of AIH published in 2002 and recently updated.

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“…Therefore, she had 'definite' AIH. In the case of AIH, multinucleated giant cells are likely observed in the acute type or chronic type with exacerbation (10). Typical clinical features are a prolonged clinical course, severe cholestasis, and progression to cirrhosis within a few months (11).…”

Section: Discussionmentioning

confidence: 99%

A Case of Adult Autoimmune Hepatitis with Histological Features of Giant Cell Hepatitis

et al. 2011

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Giant cell hepatitis is rare in adult patients. This form of hepatitis shows fast progression to cirrhosis. A 65-year-old woman was admitted to our hospital with jaundice. She was negative for hepatitis virus markers and positive for antinuclear antibodies. We diagnosed her as autoimmune hepatitis. Liver biopsy findings revealed typical features of interface hepatitis and giant cell hepatitis. Giant cells were positive for keratin 8/18, but not for keratin 19, keratin 7 or Ki-67. These results suggest that giant cell formation is associated with the fusion of matured hepatocytes rather than the active proliferation of immature cells.

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Comparison of clinical features and liver histology in acute and chronic autoimmune hepatitis

Abstract: Laboratory data and liver histology in acute AIH differed from those of chronic AIH and were clarified for the diagnosis of acute AIH.

Cited by 35 publications

References 20 publications

Acute presentation of autoimmune hepatitis: a multicentre study with detailed histological evaluation in a large cohort of patients

Acute presentation of autoimmune hepatitis: a multicentre study with detailed histological evaluation in a large cohort of patients

British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis

A Case of Adult Autoimmune Hepatitis with Histological Features of Giant Cell Hepatitis

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