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Autoimmune hepatite

Beverley Kok, Erica L W Lester, William M Lee, A James Hanje, R Todd Stravitz, Safwat Girgis, Vaishali Patel, Joshua R Peck, Christopher Esber, Constantine J Karvellas
BACKGROUND: Tumor necrosis factor-α antagonists (anti-TNF-α) have been associated with drug-induced liver injury. However, cases of anti-TNF-α-associated acute liver failure have only been rarely reported. AIMS: To identify cases of anti-TNF-α-associated acute liver failure and evaluate patterns of liver injury and common characteristics to the cases. METHODS: The United States Acute Liver Failure Study Group database was searched from 1998 to 2014...
June 2018: Digestive Diseases and Sciences
Benedetta Terziroli Beretta-Piccoli, Giorgina Mieli-Vergani, Raffaela Bertoli, Luca Mazzucchelli, Charity Nofziger, Markus Paulmichl, Diego Vergani
We report a novel association between the commonly used antimalarial medication atovaquone/proguanil and drug-induced autoimmune-like hepatitis. The patient developed severe liver disease fulfilling biochemical, immunologic, and histologic criteria for the diagnosis of autoimmune hepatitis after the inadvertent rechallenge with the offending drug, which had caused self-limited hepatitic symptoms a year previously. Over a period of 18 months, the patient underwent two follow-up liver biopsies showing progressive resolution of the liver inflammation and achieved complete biochemical and immunologic remission on steroids...
June 2017: Hepatology Communications
Ersan Ozaslan, Cumali Efe, Nihal Gokbulut Ozaslan
Autoimmune liver diseases are heterogenous disorders that share largely non-specific clinical, serological and pathological features. The correct diagnosis requires discriminative features which are highly specific, for example high-titer antimitochondrial antibodies (AMA) and florid duct lesion in primary biliary cholangitis (PBC). However, the imperfect sensitivities of these characteristic features and abuse of scoring systems led to many artificial diagnoses such as overlap syndromes and outliers for example "autoimmune cholangitis" which is now called as "AMA-negative PBC"...
November 2016: Clinics and Research in Hepatology and Gastroenterology
Olivier Chazouillères
BACKGROUND: Some patients present with features of both primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC) on the one hand and autoimmune hepatitis (AIH) on the other hand, either simultaneously or consecutively. The term 'overlap syndrome (OS)' is used to describe these settings, but lack of universal agreement on what precisely constitutes an OS has generated considerable confusion. The low prevalence of OS (roughly 10% of PBC or PSC) has made it impracticable to perform randomized controlled trials...
2015: Digestive Diseases
Nick M Baniak, Rani Kanthan
A 59-year-old female received a matched related donor stem cell transplant for chronic myelogenous leukemia. After being successfully treated with prednisone for chronic graft versus host disease that initially started 50 days posttransplant, she developed hepatic dysfunction during the steroid taper on day 531, as evidenced by jaundice, elevated liver enzymes, and increased bilirubin. Liver biopsy showed histology suggestive of autoimmune-like hepatitis, which is a rare manifestation of chronic "hepatitic" graft versus host disease...
April 2016: International Journal of Surgical Pathology
S Fabiani
Interferon (IFN)-inducible protein-10 (IP-10) is a proinflammatory chemokine, binding the chemokine (C-X-C motif) receptor 3 (CXCR3), which is found mainly on activated T cells and natural killer (NK) cells, and plays an important role in T helper (Th) 1 type inflammatory disorders (autoimmune, neoplastic, and infectious diseases). Concerning viral hepatitis, IP-10 appears to be involved on the pathogenesis of liver damage as well as on the extra-hepatic manifestations either protecting or promoting infection, depending on host immune status and genetic background...
2015: La Clinica Terapeutica
Mio Kobayashi, Yuko Kakuda, Kenichi Harada, Yasunori Sato, Motoko Sasaki, Hiroko Ikeda, Mitsuhiro Terada, Munenori Mukai, Shuichi Kaneko, Yasuni Nakanuma
AIM: To investigate histological and immunohistochemical differences in hepatitis between autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) with AIH features. METHODS: Liver needle biopsies of 41 PBC with AIH features and 43 AIH patients were examined. The activity of periportal and lobular inflammation was scored 0 (none or minimal activity) to 4 (severe), and the degree of hepatitic rosette formation and emperipolesis was semiquantatively scored 0-3...
April 7, 2014: World Journal of Gastroenterology: WJG
Cumali Efe, Ersan Ozaslan, Alexandra Heurgué-Berlot, Taylan Kav, Chiara Masi, Tugrul Purnak, Murat Torgutalp, Luigi Muratori, Solange Bresson-Hadni, Gérard Thiéfin, Thomas D Schiano, Paolo Muratori, Staffan Wahlin
BACKGROUND: Primary biliary cirrhosis (PBC)-autoimmune hepatitis (AIH) overlap syndrome is used to describe the coexistence of both diseases, with either a sequential or a simultaneous presentation in the same patient. Available studies have focused on the simultaneous form, whereas there is limited information on sequential PBC-AIH. We carried out a retrospective study of patients who sequentially developed PBC-AIH overlap syndrome. METHODS: The medical data of 1065 patients diagnosed with PBC (n=483) and AIH (n=582) were retrospectively analyzed...
May 2014: European Journal of Gastroenterology & Hepatology
Mylène Sebagh, Marcela Castillo-Rama, Daniel Azoulay, Audrey Coilly, Valérie Delvart, Marc-Antoine Allard, Alexandre Dos Santos, Catherine Johanet, Anne-Marie Roque-Afonso, Faouzi Saliba, Jean-Charles Duclos-Vallée, Didier Samuel, Anthony Jack Demetris
BACKGROUND: Autoimmune hepatitis (AIH) after liver transplantation has been defined histologically as a "hepatitic" pattern of injury, characterized by lymphoplasmacytic inflammation with necroinflammatory activity (NIA), comparable with findings seen in native livers. This definition, however, is difficult to apply in practice because specific histologic criteria are not clearly delineated. This study aimed to determine which histologic features correlated best with clinical and serologic features of dAIH...
October 15, 2013: Transplantation
Halis Şımşek, Aslı Pinar, Akif Altinbaş, Alparslan Alp, Yasemin H Balaban, Yahya Büyükaşik, Osman Özcebe, Gülşen Hasçelık, Gökhan Gedıkoğlu, Gonca Tatar
BACKGROUND/AIMS: Alpha-1 antitrypsin deficiency causes accumulation of mutant alpha-1 antitrypsin molecules in hepatocytes, and is attributed to severe liver injury even in heterozygous state. However, there is a question as to whether alpha-1 antitrypsin deficiency is only a cause of liver injury or has a worsening effect on the underlying liver disease. We aimed to determine the role of alpha-1 antitrypsin deficiency in the ongoing chronic hepatitic process. MATERIALS AND METHODS: Fifty-four patients with the diagnosis of chronic hepatitis by liver biopsy (36 chronic hepatitis B virus, 8 chronic hepatitis C virus, 7 non-alcoholic steatohepatitis, 2 primary biliary cirrhosis, and 1 autoimmune hepatitis) and 51 age- and sex-matched control subjects chosen from among healthy blood donors were included in the study...
2012: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
M L Zubkin, T A Semenenko, F K Kokoeva, V N Borisova, E P Sel'kova, V A Aleshkin
Hepatitis E belongs to the group of enetral hepatites. Its earlier cases caused by genotype I and II viruses were reported largely from epidemics affecting tropical and subtropical countries. Sporadic cases of hepatitis E recorded later in West Europe, North America, Southeast Asia, and Oceania were caused by genotype III and IV viruses. Until recently the disease has been supposed to be reversible and have positive outcome barring women at late stages of pregnancy in whom cases of fulminate clinical course and death were described...
2012: Klinicheskaia Meditsina
Vildan Ertekin, Mahya Sultan Tosun, Mukadder Ayse Selimoglu
BACKGROUND: Celiac disease (CD) is an autoimmune disease characterized by immunemediated inflammatory damage of the small intestinal mucosa, precipitated by the ingestion of gluten-containing foods. Since human leucocyte antigen DQ2 (HLA-DQ2) is a marker of nonresponsiveness to hepatits B virus (HBV) vaccine, CD may also be associated with this nonresponsiveness. OBJECTIVES: The aim of this study was to compare the responses to HBV vaccine between children with CD and healthy children...
August 2011: Hepatitis Monthly
Erika R F Siqueira, Cláudia P M S Oliveira, Maria T C Muniz, Filipe Silva, Leila M M B Pereira, Flair J Carrilho
BACKGROUND/AIM: Hyperhomocysteinemia due to Methylenetetrahydrofolate Reductase (MTHFR) gene, in particular the C677T (Ala222Val) polymorphism were recently associated to steatosis and fibrosis. We analyzed the frequency of MTHFR gene in a cross-sectional study of patients affected by Chronic Hepatitis C (CHC) from Northeast of Brazil. METHOD: One hundred seven-four untreated patients with CHC were genotyped for the C677T MTHFR. Genomic DNA was extracted from peripheral blood cells and the C677T MTHFR polymorphism was identified by PCR-RFLP...
August 19, 2011: Nutrition Journal
Cees G M Kallenberg
PURPOSE OF REVIEW: Microbial factors are supposed to play an inducing and/or reactivating role in many of the idiopathic systemic vasculitides. This review evaluates the evidence that microbes are involved in the etiopathogenesis of the disease focusing on possibilities for antimicrobial intervention. RECENT FINDINGS: The clinical presentation of hepatitis B virus (HBV)-associated polyarteritis nodosa (PAN) is different from that of non-HBV-PAN and requires antiviral treatment...
May 2011: Current Opinion in Rheumatology
S Arulprakash, Anand D Sasi, Murali R Bala, T Pugazhendhi, S Jeevan Kumar
"Overlap syndrome" is used to describe variant forms of autoimmune hepatitis (AIH) which present with characteristics of AIH and primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC). Patients with overlap syndromes present with both hepatitic and cholestatic serum liver tests and have histological features of AIH and PBC or PSC. AIH-PBC is the most common form of overlap syndrome, affecting almost 10% of adults with AIH or PBC. Transitions from PBC to AIH-PBC overlap syndrome have also been reported...
July 2010: Journal of the Association of Physicians of India
Kirsten Muri Boberg, Roger W Chapman, Gideon M Hirschfield, Ansgar W Lohse, Michael P Manns, Erik Schrumpf
Some patients present with overlapping features between disorders within the spectrum of autoimmune liver diseases (i.e. autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC)) and are commonly classified as having an "overlap syndrome". Standardized definitions of "overlap syndromes" are lacking. The aim of this report by the International Autoimmune Hepatitis Group (IAIHG) is to evaluate if there are important reasons to classify conditions with overlapping features between autoimmune liver diseases as separate diagnostic entities...
February 2011: Journal of Hepatology
Maha Guindi
Autoimmune hepatitis does not have a pathognomonic feature, and its laboratory, serologic, and histologic manifestations are shared with a variety of acute and chronic liver diseases. The disease has active and quiescent phases and thus variable histologic appearances. This article outlines the many histologic faces of autoimmune hepatitis. It discusses the fulminant and acute forms, as well as the chronic hepatitic forms. Overlap syndromes with primary biliary cirrhosis and primary sclerosing cholangitis are described...
November 2010: Clinics in Liver Disease
Sally Appleyard, Ruma Saraswati, David A Gorard
INTRODUCTION: Drugs can occasionally trigger the onset of autoimmune liver disease. CASE PRESENTATION: Three Caucasian women (aged 65, 42 and 74 years old) who were receiving long-term nitrofurantoin as prophylaxis against recurrent urinary tract infections developed hepatitic liver disease. Serological auto-antibody profiles and liver histology appearances were consistent with autoimmune hepatitis. Two of the patients presented with jaundice, and one required a prolonged hospital admission for liver failure...
2010: Journal of Medical Case Reports
Stefan Hübscher
1. Histological abnormalities are commonly present in late posttransplant biopsies from pediatric liver allograft recipients. 2. Many of the changes are seen in children who appear to be clinically well with good graft function. 3. In comparison with adults, children may be more prone to developing late rejection (possibly related to noncompliance with immunosuppression) and biliary/vascular complications, but they are much less likely to suffer problems with disease recurrence. 4. De novo autoimmune hepatitis occurs in 5% to 10% of children after transplantation and may represent a hepatitic form of late cellular rejection...
November 2009: Liver Transplantation
Ranjana W Minz, Seema Chhabra, Ritu Aggarwal, Ashim Das, Biman Saikia, Yogesh K Chawla
A 42 year old asymptomatic female detected as incipient Primary Biliary Cirrhosis/Autoimmune Hepatitis overlap during routine checkup. The biochemical profile showed evolution from a mildly deranged liver function test in 2004 along with increased erythrocyte sedimentation rate to a 4 times elevation of alkaline phosphatase in 2006 with mildly deranged alanine transaminase. Autoimmune markers demonstrable were Anti mitochondrial antibody M(2) and sp100. Histopathology showed dual features, dominant findings were of autoimmune heptatitis...
2009: Cases Journal
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