The Saudi association for the study of liver diseases and transplantation clinical practice guidelines for management of autoimmune hepatitis

Aljumah, Abdulrahman; Jarallah, Badr Al; Albenmousa, Ali; Khathlan, Abdullah Al; Zanbagi, Adnan Al; Quaiz, Mohammed Al; Al-Judaıbı, Bandar; Nabrawi, Khalid; Hamoudi, Waleed Al; Alghamdi, Mohammed; Fallatah, Hind I

doi:10.4103/sjg.sjg_159_18

Cited by 8 publications

(10 citation statements)

References 173 publications

(374 reference statements)

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“…AIH is known to respond to steroids and azathioprine in most patients, even those with advanced fibrosis and stable cirrhosis [1] [2] [3], and we have shown a significant biochemical response in serum ALT during a short-term follow-up. However, assessing a longer treatment response was not an aim of our study, and this was previously documented by several national and international studies [1] [2] [3]. Multiple regression analysis showed that among AIH patients, age was associated with evidence of cirrhosis in ultrasound examinations.…”

Section: Discussionmentioning

confidence: 77%

“…Autoimmune hepatitis (AIH) is chronic inflammatory liver disease with an unknown etiology. AIH can present as either acute or chronic hepatitis along with liver cirrhosis or end-stage liver disease [1] [2] [3] AIH is more common in young and middle-aged females with a female to male ratio of 3 -4:1 [4] [5] [6].…”

Section: Introductionmentioning

confidence: 99%

“…However, the age at diagnosis varies widely, affecting individuals from childhood to old age [1] [2] [3]. The prevalence of AIH in Western Europe is variable and is estimated at approximately 10 -17 cases/100,000 people [7] [8].…”

Section: Introductionmentioning

confidence: 99%

“…The spectrum of clinical presentations of AIH ranges from asymptomatic disease to acute severe liver failure or severe advanced liver cirrhosis [1]- [6]. AIH is characterized by elevated transaminases, liver infiltration with lymphocytes and plasma cells, and positive serum autoantibodies [1] [2] [3]. The standard treatment for AIH is steroids and immunomodulation with azathioprine [1] [2] [3].…”

Section: Introductionmentioning

confidence: 99%

“…AIH is characterized by elevated transaminases, liver infiltration with lymphocytes and plasma cells, and positive serum autoantibodies [1] [2] [3]. The standard treatment for AIH is steroids and immunomodulation with azathioprine [1] [2] [3]. In Saudi Arabia, the prevalence of AIH might be underestimated due to the high prevalence of chronic hepatitis B and C and the increasing burden of nonalcoholic fatty liver disease (NAFLD) [15] [16].…”

Section: Introductionmentioning

confidence: 99%

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Autoimmune Hepatitis Prevalence among Patients from Saudi Arabia with Chronic Liver Disease Referred for Transient Elastography

Alshanketi¹,

Jabbad²,

Baghlaf³

et al. 2021

IJCM

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Background and study aim: Autoimmune hepatitis (AIH) is a chronic liver disease that can lead to progressive liver damage. The prevalence of AIH among the general population and among chronic liver disease (CLD) patients is variable worldwide. Currently, no published data on the prevalence of AIH among Saudi or among liver disease patients from the region. In this study, we aimed to assess the prevalence of AIH among CLD patients who were referred for transient elastography (FibroScan) in Saudi Arabia. Patients and methods: A retrospective study was conducted among CLD patients who had a transient elastography (FibroScan) during the 3-year study period. We obtained demographic data and test results for serum alanine aminotransferase (ALT), bilirubin, hemoglobin (Hgb), platelets, and international normalized ratio (INR) from all patients. We compared the results of the AIH patients to those of the non-AIH patients with CLD. In addition, for AIH patients, we measured serum immunoglobulin G (IgG), antinuclear antibody (ANA), smooth muscle antibody (SMA) and ALT at 2 -6 weeks and at 3 -4 months. Results: We included 494 patients, who were predominantly female (271 (60%)) and Saudi (299 (60.5%)). Thirty patients (6.1%) had AIH, which represented the 4 th most common liver disease. Compared to non-AIH patients, AIH patients were younger (mean ages 49.9 years, SD 14.22 years, and 40.4 years, SD 13.94 years, respectively, P = 0.001). Patients with AIH had significantly lower Hgb and platelets (P = 0.008 for both) and higher ALT, bilirubin and INR (P = 0.05, 0.047 and 0.019, respectively). More than 50% of the AIH patients had cirrhosis. Older age was not associated with advanced disease stage among the AIH patients (P < 0.001). AIH represents the 4 th most common cause of CLD in patients referred for transient elastography in Saudi Arabia. AIH tends to be severe in patients at a young age, with a marked biochemical response to steroids and azathioprine treatment.

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Autoimmune Hepatitis Prevalence among Patients from Saudi Arabia with Chronic Liver Disease Referred for Transient Elastography

Alshanketi¹,

Jabbad²,

Baghlaf³

et al. 2021

IJCM

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Clinical characteristics, diagnosis and management of Sweet syndrome induced by azathioprine

Fan

Sun

et al. 2023

Clin Exp Med

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Retrospective, single-center analysis of autoimmune hepatitis in Jordanian children: clinical features, treatments, and outcomes

Altamimi,

Al Omari,

Obeidat

et al. 2024

BMC Pediatr

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Objectives This study describes clinical, biochemical, and histological features and long-term outcomes in pediatric patients diagnosed with autoimmune hepatitis (AIH) at King Abdullah University Hospital, Jordan. Design Retrospective, single-center study. Setting King Abdullah University Hospital, Jordan. Participants Inclusion of all pediatric patients with AIH diagnosed at our hospital from 2015 to 2023. Exclusion criteria was patients aged over 18 at time of diagnosis and those diagnosed elsewhere. Outcome measures Understanding clinical, biochemical, and histological AIH features in children, evaluating treatment responses, and reporting short- and long-term complications, including mortality. Results Sixteen pediatric cases were diagnosed, with an average age of 9.84 ± 4.13 years. Females comprised 75% of patients, and 31.3% presented with acute liver failure. Jaundice was the most common symptom, and hepatosplenomegaly was observed in 18% of cases. Most patients had elevated transaminase levels, along with positive anti-smooth muscle antibody (ASMA) and antinuclear antibodies (ANA). Common hematological abnormalities included anemia (56.3%) and thrombocytopenia (37.5%). All patients underwent liver biopsy, with interface hepatitis present in 81.3% of cases. Treatment mainly involved prednisone and azathioprine. Three patients died, one discontinued therapy, two patients were lost to follow-up, and 10 remained on treatment. Conclusion Autoimmune hepatitis affects Jordanian children, primarily female children. Jaundice is the most common presenting symptoms. Only Type I AIH occurred in our cohort. Although of good response to conventional treatment with steroids and immunosuppression, mortality reached 18.8%.

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The Saudi association for the study of liver diseases and transplantation clinical practice guidelines for management of autoimmune hepatitis

Cited by 8 publications

References 173 publications

Autoimmune Hepatitis Prevalence among Patients from Saudi Arabia with Chronic Liver Disease Referred for Transient Elastography

Autoimmune Hepatitis Prevalence among Patients from Saudi Arabia with Chronic Liver Disease Referred for Transient Elastography

Clinical characteristics, diagnosis and management of Sweet syndrome induced by azathioprine

Retrospective, single-center analysis of autoimmune hepatitis in Jordanian children: clinical features, treatments, and outcomes

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