1. Type I autoimmune hepatitis: clinical course and outcome in an Italian multicentre study.
- Author
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FLOREANI, A., NIRO, G., ROSA RIZZOTTO, E., ANTONIAZZI, S., FERRARA, F., CARDERI, I., BALDO, V., PREMOLI, A., OLIVERO, F., MORELLO, E., and DURAZZO, M.
- Subjects
CHRONIC active hepatitis ,AUTOIMMUNE diseases ,PATIENTS ,IMMUNOSUPPRESSION ,LIVER transplantation - Abstract
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. [ABSTRACT FROM AUTHOR] more...
- Published
- 2006
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