The prognosis of chronic active hepatitis without cirrhosis in relation to bridging necrosis

Graham, W. G.; Cooksley, E.; Bradbear, R. A.; Robinson, William S.; Harrison, M Edwyn; Halliday, June W.; Powell, Lawrie W.; Ng, Han-Seung; Seah, C. S.; Okuda, Kunio; Scheuer, Peter J.; Sherlock, Sheila

doi:10.1002/hep.1840060302

Cited by 98 publications

(8 citation statements)

References 11 publications

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“…Liver biopsies were taken in 90% of the patients, staging and grading was done according to the Modified Ishak fibrosis score and Batts and Ludwig system [ 9 , 10 ]. The typical histological features of AIH includes dense mononuclear and plasma cell infiltration, interface hepatitis and rosette formation [ 3 , 6 , 7 , 21 ]. The most common histological finding in this study were lobulitis, plasma cell infiltration and piecemeal necrosis.…”

Section: Discussionmentioning

confidence: 99%

“…A criterion has been proposed by International Autoimmune hepatitis Group (IAIHG) for diagnosis of AIH [ 5 ]. Liver histology is of utmost importance in these cases, interface hepatitis is the hallmark of the disease while lympho-plasmacytic inflammatory infiltrate is a typical feature of AIH but the absence of these histopathological features does not exclude the diagnosis [ 6 , 7 ]. It has been reported that rosette formation, giant cell hepatitis, central necrosis, lobulitis with lymphoplasmacytic infiltrate and bile duct injuries on histopathology along with high serum level of Ig G are frequently observed in acute phase of AIH [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical presentation of autoimmune hepatitis in Pakistani children

Somroo¹,

Aslam²,

Luck³

et al. 2018

Pan Afr Med J

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IntroductionAutoimmune hepatitis (AIH) is one of the most common disorder resulting in end stage liver disease (ESLD) among children. Scarce data is available in this regard from Pakistan. In this study we have analyzed clinical and biochemical parameters of children suffering from this disorder.MethodsIt was a cross sectional study conducted in the Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT) Karachi from January 2005 to June 2016. Patients aged up-to 18 years were included. AIH was diagnosed by using International Autoimmune hepatitis group (IAIHG) pre-treatment and simplified AIH score. Patients with both probable and definite score were included. Biochemical, serological, sonographic and demographics were recorded at the time of diagnosis, liver biopsy was also performed in most of the cases. Data was analyzed by using SPSS ver.20 and p-value of < 0.05 was considered significant.ResultsTotal 51 patients were enrolled most of them were females (68.6%). Mean age of presentation was around 10 years. Males had statistically significant earlier age of presentation, p-value = 0.007. The most common presenting complain was jaundice. Hypergammaglobulinemia is seen in almost all patients. Type I AIH was the most common entity while Type II AIH was statistically more significant in males p-value = 0.019. Raised GGT was also seen in male patient specifically in Type II AIH, p-value = 0.001.ConclusionAutoimmune hepatitis predominantly affects female children who have late age of presentation as compare to the males. Type I AIH was the most common while Type II AIH was more common in males and they also had raised GGT.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical presentation of autoimmune hepatitis in Pakistani children

Somroo¹,

Aslam²,

Luck³

et al. 2018

Pan Afr Med J

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“…4 B and 4 C) . Bridging necrosis is an indication of severe liver damage, and is associated with poor prognosis (Cooksley et al ,1986 ; Trump and Berezesky, 1992) . In contrast, the livers of rats that received HTHQ showed mild bridging fibrosis, diminished fibrosis in both the peripotal and centri-lobular liver and reduced deformation of the liver acinus.…”

Section: Discussionmentioning

confidence: 99%

Inhibitory Effect of 1-O-Hexyl-2,3,5-Trimethylhydroquinone on Dimethylnitrosamine-induced Liver Fibrosis in Male SD Rats

Jung

Lee

et al. 2010

Toxicological Research

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Hepatic fibrosis represents the main complication of most chronic liver disorders and, regardless of its etiology, is characterized by excessive deposition of extracellular matrix components. In this study, we examined that 1-O-Hexyl-2,3,5-Trimethylhydroquinone (HTHQ) , a potent anti-oxidative agent, could prevent experimental hepatic fibrosis induced by dimethylnitrosamine (DMN) in male SD rats. Except for vehicle control group, other groups were induced hepatic fibrosis by intraperitoneal injection with DMN (10 mg/ml/kg) on 3 consecutive days weekly for 4 weeks. During the same 4 weeks, control and DMN groups were given vehicle and HTHQ 50, 100 and 200 groups were orally administered HTHQ (50, 100, 200 mg/kg respectively) . In HTHQ 100 and 200 groups, relative liver weight and serum chemistry level improved significantly. HTHQ reduced hydroxyproline (p < 0.05) and malondialdehyde (p < 0.05) level in the liver. Histopathological examination of H&E, Masson’s trichrome stain showed the reduced fibrotic septa in HTHQ 100 and 200 groups. HTHQ administration showed reduced mRNA level of PDGF (Plateletderived growth factor) , α-SMA (α-smooth muscle actin) and TGF-β (transforming growth factor-β) than DMN-induced hepetic fibrosis animals in the liver tissue. In this study, we showed that HTHQ improves against DMN-induced liver fibrosis in male SD rats.

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“…Another placebo-controlled trial was performed by Soloway et al, in which 17 patients with chronic active hepatitis served as a placebo control [ 200 ], and again high mortality (41% died up to 3.5 years) was noted. Even without cirrhosis at presentation, AIH patients with bridging necrosis or multilobular necrosis are likely to progress to cirrhosis in a few years if untreated, and long-term prognosis is poor [ 204 , 205 ].…”

Section: Treatmentmentioning

confidence: 99%