TY - JOUR
T1 - Type I autoimmune hepatitis
T2 - Clinical course and outcome in an Italian multicentre study
AU - Floreani, A.
AU - Niro, G.
AU - Rosa Rizzotto, E.
AU - Antoniazzi, S.
AU - Ferrara, F.
AU - Carderi, I.
AU - Baldo, V.
AU - Premoli, A.
AU - Olivero, F.
AU - Morello, E.
AU - Durazzo, M.
PY - 2006/10
Y1 - 2006/10
N2 - Background: Many reports of autoimmune hepatitis (AIH) were written in the 'pre-Hepatitis C era' and data on the natural history are still incomplete. Aim: To evaluate the clinical presentation and the natural history of type I AIH. Methods: Seventy-three consecutive patients with a regular follow-up of at least 2 years were prospectively included in the study. The mean follow-up was 91 ± 61 months. Results: Patients with 'acute' onset at presentation were significantly older than patients with 'chronic' onset (P <0.05) and had significantly higher serum levels of transaminase, γ-glutamyltransferase and bilirubin; Prothrombin time was significantly lower in the said group compared with AIH patients with 'chronic' onset. In 4 of 63 (6.3%) female patients, AIH had the onset during pregnancy; in all of them the outcome of pregnancy was favourable. The major events during the follow-up included oesophageal varices (n = 9) and ascites (n = 4), and 60 patients remained in remission while receiving immunosuppression. None of the patients died during the follow-up, but seven patients were transplanted. The cumulative transplant-free probability of survival was 73.5% at 280 months. Conclusions: Elderly patients have more frequently an acute onset at presentation. Survival in AIH is apparently good; with early diagnosis, and improved medical therapy, liver transplantation for AIH will become a rare event in future.
AB - Background: Many reports of autoimmune hepatitis (AIH) were written in the 'pre-Hepatitis C era' and data on the natural history are still incomplete. Aim: To evaluate the clinical presentation and the natural history of type I AIH. Methods: Seventy-three consecutive patients with a regular follow-up of at least 2 years were prospectively included in the study. The mean follow-up was 91 ± 61 months. Results: Patients with 'acute' onset at presentation were significantly older than patients with 'chronic' onset (P <0.05) and had significantly higher serum levels of transaminase, γ-glutamyltransferase and bilirubin; Prothrombin time was significantly lower in the said group compared with AIH patients with 'chronic' onset. In 4 of 63 (6.3%) female patients, AIH had the onset during pregnancy; in all of them the outcome of pregnancy was favourable. The major events during the follow-up included oesophageal varices (n = 9) and ascites (n = 4), and 60 patients remained in remission while receiving immunosuppression. None of the patients died during the follow-up, but seven patients were transplanted. The cumulative transplant-free probability of survival was 73.5% at 280 months. Conclusions: Elderly patients have more frequently an acute onset at presentation. Survival in AIH is apparently good; with early diagnosis, and improved medical therapy, liver transplantation for AIH will become a rare event in future.
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U2 - 10.1111/j.1365-2036.2006.03104.x
DO - 10.1111/j.1365-2036.2006.03104.x
M3 - Article
C2 - 16984499
AN - SCOPUS:33748653157
VL - 24
SP - 1051
EP - 1057
JO - Alimentary Pharmacology and Therapeutics
JF - Alimentary Pharmacology and Therapeutics
SN - 0269-2813
IS - 7
ER -