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Autoimmune hepatitis with confluent necrosis indicates severe liver injury but responds well to standard immunosuppressive therapy

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dc.contributor.authorSun, Xiaoyi
dc.contributor.authorSu, Yu
dc.contributor.authorWee, Aileen
dc.contributor.authorLiu, Jimin
dc.contributor.authorWang, Qianyi
dc.contributor.authorZhang, Jingqi
dc.contributor.authorZhao, Xinyan
dc.contributor.authorJia, Jidong
dc.date.accessioned2024-06-12T11:04:22Z
dc.date.available2024-06-12T11:04:22Z
dc.date.issued2024
dc.description.abstractWe aimed to study the effects of different extensive confluent necrosis on complete biochemical response, side effects of immunosuppressants, and outcomes in patients with autoimmune hepatitis (AIH). Patients with liver biopsy, receiving standard immunosuppressive therapy (IST), and regular follow-up were retrospectively recruited. Demographic and clinicopathological characteristics between Ishak confluent necrosis scores ≤4 (the non-severe AIH group) and ≥5 (the severe AIH group) were compared. The Kaplan-Meier Survival analysis, Cox regression analysis, and log-rank test were performed. Bilateral p<0.05 was considered statistical significance. One hundred and forty-two patients were enrolled, the median age was 56.0, and 83.8% were female. There were no significant differences in aminotransferases and immunological markers between the two groups. Patients in the severe AIH group had significantly worse liver synthetic function, a higher proportion of cirrhosis, and histologically a higher degree of portal inflammation, interface hepatitis, fibrosis stage, and a higher histological activity index score (all p<0.05). Patients in the severe AIH group had a lower response than the other group after four weeks (57.1% vs. 86.3%, p=0.002). However, differences in complete biochemical response (CBR) were insignificant. Eight patients experienced end-point events. Kaplan-Meier survival analysis showed no significant difference between the two groups (p=0.343). For adverse effects of IST, patients in the severe group tended toward a higher incidence of corticosteroid adverse effects without statistical significance. Our study indicated that patients with histologically severe confluent necrosis (Ishak score ≥5) had significantly worse liver synthetic function and a higher degree of liver fibrosis before IST. Compared with their counterparts, this subgroup of patients showed delayed biochemical response but eventually comparable CBRs, side effects, and long-term outcomeses
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dc.identifier.citationHistology and Histopathology Vol. 39, nº7 (2024)
dc.identifier.doihttps://doi.org/10.14670/HH-18-690
dc.identifier.issn0213-3911
dc.identifier.issn1699-5848
dc.identifier.urihttp://hdl.handle.net/10201/142282
dc.languageenges
dc.relationSin financiación externa a la Universidades
dc.rightsinfo:eu-repo/semantics/openAccesses
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectAutoimmune hepatitises
dc.subjectInflammatory necrosises
dc.subjectBiochemical responsees
dc.subjectEnd point eventses
dc.subjectSide effectes
dc.subject.otherCDU::6 - Ciencias aplicadas::61 - Medicina::616 - Patología. Medicina clínica. Oncologíaes
dc.titleAutoimmune hepatitis with confluent necrosis indicates severe liver injury but responds well to standard immunosuppressive therapyes
dc.typeinfo:eu-repo/semantics/articlees
dspace.entity.typePublicationes
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Histology and histopathology Vol.39, nº7 (2024)