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Role of age in presentation, response to therapy and outcome of autoimmune hepatitis
- Source :
- Clinical and Translational Gastroenterology, 9:165. Nature Publishing Group, Baven-Pronk, M A M C, Biewenga, M, van Silfhout, J J, van den Berg, A P, van Buuren, H R, Verwer, B J, van Nieuwkerk, C M J, Bouma, G & van Hoek, B 2018, ' Role of age in presentation, response to therapy and outcome of autoimmune hepatitis article ', CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY, vol. 9, no. 6, 165 . https://doi.org/10.1038/s41424-018-0028-1, Clinical and Translational Gastroenterology, 9, Clinical and Translational Gastroenterology, Clinical and translational gastroenterology, 9(6):165, 1-12. Nature Publishing Group, CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY, 9(6):165. Nature Publishing Group
- Publication Year :
- 2018
-
Abstract
- Background: Few studies with diverging results and a small sample size have compared autoimmune hepatitis (AIH) in the elderly to younger patients.Aim: To unbiasedly investigate the role of age in behaviour and treatment outcome of AIH.Methods: All patients with probable or definite AIH type 1 in four tertiary academic centres were included in this retrospective- and since 2006 prospective-cohort study. Influence of age on presentation, remission and outcome of AIH were investigated.Results: 359 patients were included. Presence of cirrhosis at AIH diagnosis around 30% was independent of age. ALAT was higher at age 30-60 years on AIH diagnosis, and above age 60 there were less acute onset, less jaundice and more concurrent autoimmune disease. Remission was reached in 80.2%, incomplete remission in 18.7%, only 1.1% (all aged 50-65) was treatment-refractory. Age was not an independent predictor of remission, while cirrhosis was. Above age 45 there was more diabetes, above age 60 more loss of remission. Rate of progression to cirrhosis was 10% in the 10 years after diagnosis and unrelated to age at AIH diagnosis. With onset below age 30, there was more development of decompensated cirrhosis over time. With higher age at AIH diagnosis there was a lower survival free of liver-related death or liver transplantation.Conclusions: AIH presents at all ages. Age influences features at diagnosis, but not response to treatment, while survival without liver-related death or liver transplantation decreases with higher age at diagnosis.
- Subjects :
- Liver Cirrhosis
Male
Pediatrics
Cirrhosis
medicine.medical_treatment
Anti-Inflammatory Agents
Autoimmune hepatitis
Liver transplantation
DISEASE
0302 clinical medicine
Risk Factors
immune system diseases
Age of Onset
Young adult
Child
CIRRHOSIS
Aged, 80 and over
Remission Induction
Gastroenterology
WOMEN
Alanine Transaminase
Middle Aged
Jaundice
Hepatitis, Autoimmune
Treatment Outcome
Child, Preschool
030220 oncology & carcinogenesis
Disease Progression
Female
030211 gastroenterology & hepatology
medicine.symptom
Adult
medicine.medical_specialty
Adolescent
DIAGNOSIS
Article
Young Adult
03 medical and health sciences
SDG 3 - Good Health and Well-being
MANAGEMENT
medicine
Humans
Glucocorticoids
TYPE-1
Aged
Retrospective Studies
OLDER
Hepatitis
business.industry
CLINICAL-FEATURES
Retrospective cohort study
REMISSION
Alkaline Phosphatase
medicine.disease
Survival Analysis
digestive system diseases
Age of onset
business
Subjects
Details
- Language :
- English
- ISSN :
- 2155384X
- Database :
- OpenAIRE
- Journal :
- Clinical and Translational Gastroenterology, 9:165. Nature Publishing Group, Baven-Pronk, M A M C, Biewenga, M, van Silfhout, J J, van den Berg, A P, van Buuren, H R, Verwer, B J, van Nieuwkerk, C M J, Bouma, G & van Hoek, B 2018, ' Role of age in presentation, response to therapy and outcome of autoimmune hepatitis article ', CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY, vol. 9, no. 6, 165 . https://doi.org/10.1038/s41424-018-0028-1, Clinical and Translational Gastroenterology, 9, Clinical and Translational Gastroenterology, Clinical and translational gastroenterology, 9(6):165, 1-12. Nature Publishing Group, CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY, 9(6):165. Nature Publishing Group
- Accession number :
- edsair.doi.dedup.....9c15c9945fd34403d449acd26e33e543