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Autoimmune hepatitis Histopathologic and clinical diagnosis

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https://www.readbyqxmd.com/read/29108197/-advances-in-clinical-differentiation-between-immunological-and-drug-induced-liver-injury
#1
Y Wang, Y N Li, J Zhang, B M Wang, L Zhou
The differentiation between autoimmune hepatitis (AIH) and drug-induced liver injury (DILI) is a difficult task in clinical practice. Some AIH patients had a medication history before disease onset, and some DILI patients may have positive serum antibody. In addition, these two groups of patients have similar clinical symptoms, serological examination results, and liver histopathology, which lead to the difficulties in differentiation. However, correct differential diagnosis is of great significance in making clinical treatment decisions and preventing liver cirrhosis...
September 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29040982/clinicopathological-study-of-autoimmune-hepatitis-cases-that-were-difficult-to-differentiate-from-drug-induced-liver-injury
#2
Akemi Tsutsui, Kenichi Harada, Koichi Tsuneyama, Tomonori Senoh, Takuya Nagano, Koichi Takaguchi, Midori Ando, Satoko Nakamura, Koichi Mizobuchi, Masatoshi Kudo
AIM: Acute-onset autoimmune hepatitis (AIH) histopathologically presents with features of acute hepatitis and lacks a specific diagnostic method. Also, AIH is often difficult to differentiate from drug-induced liver injury (DILI). We aimed to investigate the final clinical diagnosis of these cases, and compare the clinical, biochemical, and histological characteristics of AIH vs. DILI. METHODS: We examined the Digestive Disease Week Japan 2004 (DDW-J) scale scores, AIH scores, clinical data, and pathological findings in 20 patients in whom it was difficult to differentiate autoimmune liver disease from DILI...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/29035910/new-predictive-factors-of-poor-response-to-therapy-in-autoimmune-hepatitis-role-of-mean-platelet-volume
#3
Ahmed Abdel-Razik, Nasser Mousa, Sahar Zakaria, Rania Elhelaly, Rasha Elzehery, Khaled Zalata, Mahmoud Awad, Ahmed A Eldeeb, Mostafa Abdelsalam
BACKGROUND AND OBJECTIVES: The response to immunosuppressive therapy in autoimmune hepatitis (AIH) is a matter of debate. The aim of this work is to identify the histological, biochemical, and clinical predictive factors of incomplete response/treatment failure to the standard treatment (prednisone with or without azathioprine) in a well-characterized series of AIH Egyptian patients. PATIENTS AND METHODS: Of 49 AIH patients, only 36 patients completed this retrospective cohort study...
October 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28794251/clinicopathologic-features-of-myositis-patients-with-cd8-mhc-1-complex-pathology
#4
Chiseko Ikenaga, Akatsuki Kubota, Masato Kadoya, Kenichiro Taira, Naohiro Uchio, Ayumi Hida, Meiko Hashimoto Maeda, Yu Nagashima, Hiroyuki Ishiura, Kenichi Kaida, Jun Goto, Shoji Tsuji, Jun Shimizu
OBJECTIVE: To determine the clinical features of myositis patients with the histopathologic finding of CD8-positive T cells invading non-necrotic muscle fibers expressing major histocompatibility complex class 1 (CD8-MHC-1 complex), which is shared by polymyositis (PM) and inclusion body myositis (IBM), in relation to the p62 immunostaining pattern of muscle fibers. METHODS: All 93 myositis patients with CD8-MHC-1 complex who were referred to our hospital from 1993 to 2015 were classified on the basis of the European Neuromuscular Center (ENMC) diagnostic criteria for IBM (Rose, 2013) or PM (Hoogendijk, 2004) and analyzed...
September 5, 2017: Neurology
https://www.readbyqxmd.com/read/28523968/gastrointestinal-system-involvement-in-systemic-lupus-erythematosus
#5
Z Li, D Xu, Z Wang, Y Wang, S Zhang, M Li, X Zeng
Systemic lupus erythematosus (SLE) is a multisystem disorder which can affect the gastrointestinal (GI) system. Although GI symptoms can manifest in 50% of patients with SLE, these have barely been reviewed due to difficulty in identifying different causes. This study aims to clarify clinical characteristics, diagnosis and treatment of the four major SLE-related GI system complications: protein-losing enteropathy (PLE), intestinal pseudo-obstruction (IPO), hepatic involvement and pancreatitis. It is a systematic review using MEDLINE and EMBASE databases and the major search terms were SLE, PLE, IPO, hepatitis and pancreatitis...
October 2017: Lupus
https://www.readbyqxmd.com/read/28457528/disease-associations-with-isolated-elevations-of-each-of-the-four-igg-subclasses
#6
Sarah Engelhart, Robert J Glynn, Peter H Schur
PURPOSE: Immunoglobulin G4-related disease (IgG4-RD) is a relatively newly defined disease entity that refers to a group of immune-mediated disorders that have certain histopathologic, serologic, and clinical features in common. IgG4-RD is often associated with elevated serum IgG4. The discovery of IgG4-RD highlights the scarcity of literature examining elevations in other IgG subclasses and their potential associations to disease. In this retrospective chart review study, we aim to address that gap, by exploring disease associations in patients with isolated IgG subclass elevations...
March 30, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/27957241/recent-advances-in-the-diagnosis-and-treatment-of-primary-biliary-cholangitis
#7
REVIEW
Ying-Qiu Huang
Primary biliary cholangitis (PBC), formerly referred to as primary biliary cirrhosis, is an infrequent progressive intrahepatic cholestatic autoimmune illness that can evolve into hepatic fibrosis, hepatic cirrhosis, hepatic failure, and, in some cases, hepatocellular carcinoma. The disease itself is characterized by T-lymphocyte-mediated chronic non-suppurative destructive cholangitis and elevated serum levels of extremely specific anti-mitochondrial autoantibodies (AMAs). In this article, we will not only review epidemiology, risk factors, natural history, predictive scores, radiologic approaches (e...
November 28, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/26824512/-biliary-diseases-with-pancreatic-counterparts-cross-sectional-imaging-findings
#8
REVIEW
Venkata S Katabathina, Erin M Flaherty, Anil K Dasyam, Christine O Menias, Nicole D Riddle, Narayan Lath, Kazuto Kozaka, Osamu Matsui, Yasuni Nakanuma, Srinivasa R Prasad
On the basis of the similarities in the histopathologic findings and the clinical-biologic behaviors of select biliary and pancreatic conditions, a new disease concept, "biliary diseases with pancreatic counterparts," has been proposed. Both nonneoplastic and neoplastic pathologic conditions of the biliary tract have their counterparts in the pancreas. Immunoglobulin G4 (IgG4)-related sclerosing cholangitis is the biliary manifestation of IgG4-related sclerosing disease, and type 1 autoimmune pancreatitis is its pancreatic counterpart...
March 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/26642062/role-of-histopathology-in-autoimmune-hepatitis
#9
REVIEW
Dina G Tiniakos, John G Brain, Yvonne A Bury
The diagnosis of autoimmune hepatitis (AIH) is based on a combination of biochemical, immunological and histological features and exclusion of other causes of liver disease. Typical histological features include a chronic hepatitis pattern of injury with portal inflammation and interface activity, predominance of plasma cells in the portal infiltrate, emperipolesis, and hepatocellular rosette formation. Centrilobular injury with prominent hepatocellular necrosis and mononuclear inflammation is now recognised in the histological spectrum of AIH and may represent an early stage of the disease...
2015: Digestive Diseases
https://www.readbyqxmd.com/read/26585107/-recurrence-of-primary-diseases-after-liver-transplantation
#10
Víta Žampachová, Eva Honsová
A majority of primary diseases for which orthotopic liver transplantation is carried out may recur in the liver allograft, mostly in adults. As the indication criteria, transplantation surgery and post-transplantation care improve, the patients survival lengthens as well, leading to concurrently increasing incidence as well as an increase in the relevance of recurrent diseases, which are the most significant cause of late liver graft dysfunction. The frequency, clinical consequences and therapeutic options of different disease recurrence vary considerably...
2015: Ceskoslovenská Patologie
https://www.readbyqxmd.com/read/26515574/immune-mediated-necrotizing-myopathy-update-on-diagnosis-and-management
#11
REVIEW
Pari Basharat, Lisa Christopher-Stine
The idiopathic inflammatory myopathies (IIMs) comprise a group of autoimmune disorders that target skeletal muscle. They are characterized by typical laboratory and clinical features including muscle weakness, elevated muscle enzymes, characteristic histopathology of muscle biopsies, as well as electromyography abnormalities. The IIMs are divided into polymyositis, dermatomyositis, inclusion body myositis, nonspecific myositis, and immune-mediated necrotizing myopathy (IMNM). IMNM is distinguished by the absence of primary inflammation on muscle biopsy...
December 2015: Current Rheumatology Reports
https://www.readbyqxmd.com/read/26393179/chronic-liver-diseases-in-children-clinical-profile-and-histology
#12
Sachin Devidas Dhole, Archana S Kher, Radha G Ghildiyal, Manjusha P Tambse
AIM: The main aim of the study is to study the clinical profile of disorders of the liver and hepatobiliary system in paediatric patients and to correlate the histopathology findings of liver biopsy in chronic liver disease. Another aim being to assess the prognosis and to know the outcome and the effects of treatment in chronic liver diseases in paediatric age group. MATERIALS AND METHODS: It was a prospective study, included the clinical profile of Chronic Liver Diseases (CLD) in children and the histopathological correlation...
July 2015: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/26228830/superficial-morphea-of-the-lips-and-gingiva
#13
LETTER
Vanja Vučićević Boras, Dora Gabrić, Vlaho Brailo, Nada Čikeš, Danko Velimir Vrdoljak
No abstract text is available yet for this article.
2015: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/26063488/fibrillary-glomerulonephritis-an-apparent-familial-form
#14
Tracey Ying, Prue Hill, Michael Desmond, John Agar, Andrew Mallett
Fibrillary glomerulonephritis is a rare cause of glomerulonephritis characterized by non-amyloid fibrillary deposits of unknown aetiology. It is generally considered idiopathic but may be associated with secondary causes such as monoclonal gammopathy, hepatitis B and C infections, autoimmune diseases and malignancies. We report two Australian families with apparent familial fibrillary glomerulonephritis inherited in an autosomal dominant pattern, and postulate the existence of a primary familial entity. Family 1 consists of an affected father and daughter; the daughter progressed to end-stage renal failure within 18 months of diagnosis, despite immunosuppressive therapy...
July 2015: Nephrology
https://www.readbyqxmd.com/read/25926402/clinical-and-histological-features-of-idiosyncratic-liver-injury-dilemma-in-diagnosis-of-autoimmune-hepatitis
#15
Ufuk Bariş Kuzu, Erkin Öztaş, Nesrin Turhan, Fatih Saygili, Nuretdin Suna, Hakan Yildiz, Mustafa Kaplan, Muhammet Yener Akpinar, Meral Akdoğan, Sabite Kaçar, Zeki Mesut Yalin Kiliç, Aydin Şeref Köksal, Bülent Ödemiş, Ertuğrul Kayaçetin
AIM: Drug-induced liver injury (DILI) is becoming a worldwide problem with its still unexplained properties. METHODS: The data of patients who were diagnosed with DILI between January 2008 and December 2013 were assessed. RESULTS: Five patients had been diagnosed with intrinsic and 82 patients with idiosyncratic DILI. The most common causative agents were antimicrobial drugs. The most common injury pattern was hepatocellular. When patients with bilirubin levels of more than 5 mg/dL were divided into two groups according to receiving steroid therapy (n = 11) or not (n = 40), there was not any significant difference according to their clinical results (P > 0...
April 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/25473583/an-autopsy-case-of-unicentric-castleman-s-disease-associated-with-bronchiolitis-obliterans
#16
Koichi Kobayashi, Nobuharu Ohshima, Masahiro Shimada, Masahiro Kawashima, Hirotoshi Matsui, Akira Hebisawa
A 34-year-old woman visited the hospital suffering from enanthema of the tongue, hair loss, and nonproductive cough. Corticosteroid administration slightly resolved the enanthema and hair loss, but not the nonproductive cough. She was transferred to another hospital for the resection of a retroperitoneal mass, which was histopathologically diagnosed as unicentric, hyaline vascular type Castleman's disease. She was then referred to our hospital due to progressive dyspnea and was diagnosed as having bronchiolitis obliterans based on computed tomography scan findings and a lung function test, while paraneoplastic pemphigus was clinically considered for her enanthema...
September 2014: Respirology Case Reports
https://www.readbyqxmd.com/read/25456212/autoimmune-hepatitis-in-children-progression-of-20-cases-in-northern-mexico
#17
J Nares-Cisneros, Y Jaramillo-Rodríguez
BACKGROUND: Autoimmune hepatitis (AIH) is a chronic inflammatory disease of the liver with nonspecific clinical manifestations that causes greater liver damage in children than in adults. AIMS: To analyze the clinical progression, biochemical profiles, histopathologic changes, and treatment response in 20 children with AIH. MATERIAL AND METHODS: A retrospective study was carried out on the variables associated with clinical progression, diagnosis, and treatment response in children seen at the the Unidad Médica de Alta Especialidad (UMAE) No...
October 2014: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/25257662/assessment-of-the-histopathological-key-features-in-autoimmune-hepatitis
#18
Ynto S de Boer, Carin M J van Nieuwkerk, Birgit I Witte, Chris J J Mulder, Gerd Bouma, Elisabeth Bloemena
AIMS: In this study, we aimed to evaluate the use of typical histological features of both the revised original (1999) and simplified (2008) criteria in the diagnosis of autoimmune hepatitis (AIH) in clinical practice. METHODS AND RESULTS: We performed a detailed histopathological evaluation of the pretreatment biopsies of 63 AIH patients, and used biopsies of 62 untreated chronic viral hepatitis patients [hepatitis B (n = 21) or hepatitis C (n = 41)] as a reference cohort...
February 2015: Histopathology
https://www.readbyqxmd.com/read/25018850/challenge-of-liver-disease-in-systemic-lupus-erythematosus-clues-for-diagnosis-and-hints-for-pathogenesis
#19
REVIEW
Fernando Bessone, Natalia Poles, Marcelo G Roma
Systemic lupus erythematosus (SLE) encompass a broad spectrum of liver diseases. We propose here to classify them as follows: (1) immunological comorbilities (overlap syndromes); (2) non-immunological comorbilities associated to SLE; and (3) a putative liver damage induced by SLE itself, referred to as "lupus hepatitis". In the first group, liver injury can be ascribed to overlapping hepatopathies triggered by autoimmune mechanisms other than SLE occurring with higher incidence in the context of lupus (e.g...
June 27, 2014: World Journal of Hepatology
https://www.readbyqxmd.com/read/24282356/diagnosis-of-igg4-related-sclerosing-cholangitis
#20
REVIEW
Takahiro Nakazawa, Itaru Naitoh, Kazuki Hayashi, Katsuyuki Miyabe, Shuya Simizu, Takashi Joh
IgG4-related sclerosing cholangitis (IgG4-SC) is often associated with autoimmune pancreatitis. However, the diffuse cholangiographic abnormalities observed in IgG4-SC may resemble those observed in primary sclerosing cholangitis (PSC), and the presence of segmental stenosis suggests cholangiocarcinoma (CC). IgG4-SC responds well to steroid therapy, whereas PSC is only effectively treated with liver transplantation and CC requires surgical intervention. Since IgG4-SC was first described, it has become a third distinct clinical entity of sclerosing cholangitis...
November 21, 2013: World Journal of Gastroenterology: WJG
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