检索结果-南通市图书馆

autoimmune hepatitis-related Cirrhosis： Clinical Features and Effectiveness of Immunosuppressive Treatment in Chinese Patients

引用

Chinese Medical Journal 2016年第20期129卷 2434-2440页

作者： Yan-Ni Li Huan Ma Lu Zhou Jie Zhang Li-Ping Guo Shu-Qian Li Yi-Qi Qian Bang-Mao Wang Department of Gastroenterology and Hepatology Tianjin Medical University General HospitalTianjin Medical UniversityTianjin 300054China Department of Gastroenterology and Hepatology Hebei Medical University Third HospitalHebei Medical UniversityShijiazhuangHeibei 050051China Department of Preventive Medicine School of Public HealthTianjin Medical UniversityTianjin 300070China

Background：The long-term outcomes of patients with autoimmune hepatitis （AIH） given the immunosuppressive treatment are considered to be preferable.However,little is known about the response of AIH patients with cirrhosis to immunosuppressive treatment.We assessed the effects of immunosuppressive therapy in Chinese AIH patients with cirrhosis from a tertiary hospital.Methods：Patients with a clinical diagnosis of AIH January 2000 and December 2015 were retrospectively reviewed.Two-hundred and fourteen patients who were followed up and satisfied the simplified AIH criteria were included in the study.Among these patients,87 presented with cirrhosis when initially diagnosed for AIH.Immunosuppressive treatments were employed in 57 AIH patients who did not present with cirrhosis and 39 patients who presented with cirrhosis.Initial responses to immunosuppressive treatment of patients with and without cirrhosis were analyzed.Independent risk factors were assessed for predicting the prognosis of patients.The t-test and Cox regression statistical analysis were used.Results：In total,96 AIH patients including 39 with cirrhosis and 57 without cirrhosis underwent immunosuppressive therapy.The overall complete remission after initial immunosuppressive treatment was achieved in 81/96 patients （84.4%）,whereas 9/96 （9.4%） achieved incomplete response,and 6/96 （6.3%） occurred treatment failure.Compared to noncirrhotic patients,patients who presented with cirrhosis responded to treatment to a comparable extent regarding complete response （noncirrhosis 50/57 [87.7%] vs.cirrhosis 31/39 [79.5%],P =0.275）,incomplete remission （noncirrhosis 4/57 [7.0%] vs.cirrhosis 5/39 [12.8%],P =0.338）,and treatment failure （noncirrhosis 3/57 [5.3%] vs.cirrhosis 3/39 [7.7%],P =0.629）.Importantly,the remission rate was comparable （54/57 [94.7%] and 36/39 [92.3%],P =0.629） for noncirrhotic and cirrhotic patients after immunosuppressive therapy.Compared to patients who maintained remission （n =19） after drug withdrawal,patients who experienced relapse （n

关键词： autoimmune hepatitis Immunosuppressive Agents Liver Cirrhosis Treatment Outcome

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

autoimmune hepatitis in the Asia-Pacific Area

引用

Journal of Clinical and Translational Hepatology 2018年第1期6卷 48-56页

作者： Qi-Xia Wang Li Yan Xiong Ma Division of Gastroenterology and Hepatology Key Laboratory of Gastroenterology and HepatologyMinistry of HealthState Key Laboratory for Oncogenes and Related GenesRenji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai Institute of Digestive DiseaseShanghaiChina

autoimmune hepatitis has been considered as a relatively rare immunological liver disease,especially in the Asia-Pacific area.Although the diagnosis criteria and immunosuppressive treatment regimens have been established,there are still some challenges.According to the different presentations,the personalized management of patients who suffer from this disease,including those with chronic or acute severe onset,the autoantibody-negative phenotype and cirrhosis are necessarily descriptive.Each subgroup of patients should receive an individualized therapy.Here,we review the recent studies of autoimmune hepatitis,mainly focusing on the epidemiology and genetics,personalized diagnostics,individualized treatment strategies,special subgroups and outcomes.Most of the research in the literature is based on Japanese and Chinese populations.

关键词： autoimmune hepatitis Outcome Personalized management Asia Pacific area

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

autoimmune hepatitis: standard treatment and systematic review of alternative treatments

引用

World Journal of Gastroenterology 2017年第33期23卷 6030-6048页

作者： Benedetta Terziroli Beretta-Piccoli Giorgina Mieli-Vergani Diego Vergani Epatocentro Ticino Paediatric Liver GI and Nutrition CentreMowat LabsKing’s College Hospital Institute of Liver Studies Mowat LabsKing’s College Hospital

autoimmune hepatitis is a rare chronic inflammatory liver disease,affecting all ages,characterised by elevated transaminase and immunoglobulin G levels,positive autoantibodies,interface hepatitis at liver histology and good response to immunosuppressive treatment. If untreated,it has a poor prognosis. The aim of this review is to summarize the evidence for standard treatment and to provide a systematic review on alternative treatments for adults and children. Standard treatment is based on steroids and azathioprine,and leads to disease remission in 80%-90% of patients. Alternative first line treatment has been attempted with budesonide or cyclosporine,but their superiority compared to standard treatment remains to be demonstrated. Second-line treatments are needed for patients not responding or intolerant to standard treatment. No randomized controlled trials have been performed for second-line options. Mycophenolate mofetil is the most widely used second-line drug,and has good efficacy particularly for patients intolerant to azathioprine,but has the major disadvantage of being teratogenic. Only few and heterogeneous data on cyclosporine,tacrolimus,everolimus and sirolimus are available. More recently,experience with the anti-tumour necrosis factoralpha infliximab and the anti-CD20 rituximab has been published,with ambivalent results; these agents may have severe side-effects and their use should be restricted to specialized centres. Clinical trials with new therapeutic options are ongoing.

关键词： autoimmune hepatitis Standard treatment Second-line treatment Adults Children

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

autoimmune hepatitis

引用

Frontiers of Medicine 2015年第2期9卷 187-219页

作者： Farhad Sahebjam John M. Vierling Departments of Medicine and Surgery Baylor College of Medicine Baylor-St. Luke's Medical Center Houston TX 77030 USA

autoimmune hepatitis is a chronic liver disease putatively caused by loss of tolerance to hepatocyte- specific autoantigens. It is characterized by female predilection, elevated aminotransferase levels, autoantibodies, increased y-globulin or IgG levels and biopsy evidence of interface hepatitis. It is currently divided into types 1 and 2, based on expression of autoantibodies. Autoantigenic epitopes have been identified only for the less frequent type 2. Although autoimmune hepatitis occurs in childhood, this review focuses on disease in adults. In the absence of pathognomonic biomarkers, diagnosis requires consideration of clinical, biochemical, serological and histological features, which have been codified into validated diagnostic scoring systems. Since many features also occur in other chronic liver diseases, these scoring systems aid evaluation of the differential diagnosis. New practice guidelines have redefined criteria for remission to include complete biochemical and histological normalization on immunosuppressive therapy. Immunosuppression is most often successful using prednisone or prednisolone and azathioprine; however, the combination of budesonide and azathioprine for non-cirrhotic patients offers distinct advantages. Patients failing standard immunosuppression are candidates for alternative immunosuppressive regimens, yet none of the options has been studied in a randomized, controlled trial. Overlap syndromes with either primary sclerosing cholangitis or primary biliary cirrhosis occur in a minority. Liver transplantation represents a life-saving option for patients presenting with acute liver failure, severely decompensated cirrhosis or hepatocellular carcinoma. Transplant recipients are at risk for recurrent autoimmune hepatitis in the allograft, and de novo disease may occur in patients transplanted for other indications. Patients transplanted for AIH are also at risk for recurrent or de novo inflammatory bowel disease. Progress in our understanding of the immunopathogenesis should lead to i

关键词： autoimmune hepatitis autoantibodies diagnosis immunological diseases drug-induced liver injury therapy immunosuppression outcomes hepatocellular carcinoma liver transplantation

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

autoimmune hepatitis Induced after Treatment of Syphilitic hepatitis

引用

Journal of Clinical and Translational Hepatology 2022年第1期10卷 174-177页

作者： Hasan Ali Taqi Rizvi Mumtaz Niazi Mark Galan Nikolaos Pyrsopoulos Department of Internal Medicine Rutgers University New Jersey Medical SchoolNewarkNJUSA Edward Via College of Osteopathic Medicine SpartanburgSCUSA Division of Gastroenterology and Hepatology Rutgers University New Jersey Medical SchoolNewarkNJUSA Department of Pathology Immunology and Laboratory MedicineRutgers University New Jersey Medical SchoolNewarkNJUSA

We present a unique case of biopsy-proven syphilitic hepa-titis which presented as severe acute liver injury with sig-nificant elevation in aminotransferases and bilirubin,and improved with antibiotic therapy.However,the patient re-turned weeks after initial presentation with new-onset acute liver injury and had developed hypergammaglobulinemia,positive autoantibody titers,and repeat liver biopsy dem-onstrating interface hepatitis,supporting a diagnosis of autoimmune hepatitis.He had an otherwise unrevealing etiologic workup,and responded to glucocorticoid therapy.We believe that syphilitic hepatitis and its treatment sub-sequently triggered an immunogenic response,leading to autoimmune hepatitis.autoimmune hepatitis is a chronic liver disease thought to manifest as a result of predisposing genetic factors in combination with environmental insults,especially hepatotropic pathogens.Syphilis is a sexually transmitted disease caused by Treponema pallidum that has been associated with autoimmunity and the develop-ment of autoantibodies.We propose that in the setting of syphilitic hepatitis,a molecular mimicry event resulting from structural similarities between T.pallidum and liver antigens,as well as impaired regulatory T-cell function,led to the breakdown of immune tolerance and the onset of au-toimmune hepatitis.To support this hypothesis,further mo-lecular analyses and case series are necessary to determine if syphilitic hepatitis and its treatment are risk factors for the onset of autoimmune hepatitis.autoimmune hepatitis should be considered early as the cause of acute liver injury in susceptible patients with risk factors for the disease,as prompt recognition and appropriate treatment may prevent progression of liver injury and result in improved outcomes.

关键词： autoimmune hepatitis Syphilis Molecular mimicry

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

autoimmune hepatitis-primary biliary cholangitis overlap syndrome complicated by various autoimmune diseases:A case report

引用

World Journal of Clinical Cases 2024年第6期12卷 1174-1181页

作者： Yu-Jie Qin Ting Gao Xing-Nian Zhou Ming-Liang Cheng Hong Li Clinical Medicine School of Guizhou Medical University Guiyang 550025Guizhou ProvinceChina Department of Pathology The Affiliated Hospital of Guizhou Medical UniversityGuiyang 550025Guizhou ProvinceChina Department of Infectious Diseases Guizhou Medical UniversityGuiyang 550025Guizhou ProvinceChina Department of Infectious Diseases Guizhou Provincial People's HospitalGuiyang 550025Guizhou ProvinceChina

BACKGROUND autoimmune hepatitis(AIH)and primary biliary cholangitis(PBC)are two common clinical autoimmune liver diseases,and some patients have both diseases;this feature is called AIH-PBC overlap syndrome.autoimmune thyroid disease(AITD)is the most frequently overlapping extrahepatic autoimmune disease.Immunoglobulin(IgG)4-related disease is an autoimmune disease recognized in recent years,characterized by elevated serum IgG4 levels and infiltration of IgG4-positive plasma cells in tissues.CASE SUMMARY A 68-year-old female patient was admitted with a history of right upper quadrant pain,anorexia,and jaundice on physical examination.Laboratory examination revealed elevated liver enzymes,multiple positive autoantibodies associated with liver and thyroid disease,and imaging and biopsy suggestive of pancreatitis,hepatitis,and PBC.A diagnosis was made of a rare and complex overlap syndrome of AIH,PBC,AITD,and IgG4-related disease.Laboratory features improved on treatment with ursodeoxycholic acid,methylprednisolone,and azathioprine.CONCLUSION This case highlights the importance of screening patients with autoimmune diseases for related conditions.

关键词： Overlap syndrome autoimmune hepatitis Primary biliary cholangitis Primary sclerosing cholangitis autoimmune thyroid disease Case report

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

autoimmune hepatitis in the setting of human immunodeficiency virus infection: A case series

引用

World Journal of Hepatology 2017年第36期9卷 1367-1371页

作者： Emmanuel Ofori Daryl Ramai Mel A Ona Madhavi Reddy Division of Gastroenterology and Hepatology the Brooklyn Hospital Center Academic Affiliate of the Icahn School of Medicine at Mount Sinai Clinical Affiliate of the Mount Sinai Hospital Department of Anatomical Sciences St. George’s University School of Medicine Division of Advanced Endoscopy Cedars-Sinai Medical Center

Liver injury in the setting of human immunodeficiency virus(HIV) infection is more commonly attributed to viral hepatitis or highly active antiretroviral treatment(HAART) toxicity. The severity of liver injury is an important cause of morbidity and mortality. The emergence of autoimmune diseases, particularly autoimmune hepatitis(AIH) in the setting of HIV infection, is rare. Previous reports indicate that elevated liver enzymes are a common denominator amongst these patients. We present two patients with HIV infection, on HAART, with virological suppression. Both patients presented with elevated liver enzymes, and following liver biopsies, were diagnosed with AIH. The clinical course of these patients underscore the therapeutic value of corticosteroids, and in some cases, addition of immunosuppression for AIH treatment.

关键词： Liver biopsy Human immunodeficiency virus Immunosuppression Autoimmunity autoimmune hepatitis

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

autoimmune hepatitis and primary sclerosing cholangitis after direct-acting antiviral treatment for hepatitis C virus:A case report

引用

World Journal of Hepatology 2024年第2期16卷 286-293页

作者： Yoshiki Morihisa Hobyung Chung Shuichiro Towatari Daisuke Yamashita Tetsuro Inokuma Department of Gastroenterology and Hepatology Kobe City Medical Center General HospitalKobe 650-0047HyogoJapan Department of Pathology Kobe City Medical Center General HospitalKobe 650-0047HyogoJapan

BACKGROUND Chronic hepatitis C virus(HCV)infection is a major global health concern that leads to liver fibrosis,cirrhosis,and cancer.Regimens containing direct-acting antivirals(DAAs)have become the mainstay of HCV treatment,achieving a high sustained virological response(SVR)with minimal adverse events.CASE SUMMARY A 74-year-old woman with chronic HCV infection was treated with the DAAs ledipasvir,and sofosbuvir for 12 wk and achieved SVR.Twenty-four weeks after treatment completion,the liver enzyme and serum IgG levels increased,and antinuclear antibody became positive without HCV viremia,suggesting the development of autoimmune hepatitis(AIH).After liver biopsy indicated AIH,a definite AIH diagnosis was made and prednisolone was initiated.The treatment was effective,and the liver enzyme and serum IgG levels normalized.However,multiple strictures of the intrahepatic and extrahepatic bile ducts with dilatation of the peripheral bile ducts appeared on magnetic resonance cholangiopancreatography after 3 years of achieving SVR,which were consistent with primary sclerosing cholangitis.CONCLUSION The potential risk of developing autoimmune liver diseases after DAA treatment should be considered.

关键词： Liver hepatitis C virus autoimmune hepatitis Primary sclerosing cholangitis Immune system Case report

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

autoimmune hepatitis and eosinophilia:A rare case report

引用

World Journal of Hepatology 2023年第2期15卷 311-317页

作者： Isabel Garrido Susana Lopes Elsa Fonseca Fátima Carneiro Guilherme Macedo Department of Gastroenterology and Hepatology Centro Hospitalar Universitário de São JoãoWorld Gastroenterology Organization Porto Training CenterFaculty of Medicine of the University of PortoPortoPortugal Department of Pathology Centro Hospitalar Universitário de São JoãoInstituto de Investigação e Inovação em Saúde(i3S)and Institute of Molecular Pathology and ImmunologyUniversity of Porto(Ipatimup)Faculty of Medicine of the University of PortoPortoPortugal

BACKGROUND autoimmune hepatitis consists of a chronic liver disease whose etiology is unknown.It is comprised of relevant immunological aspects and of immunemediated liver injury.Eosinophilia may be a considerable feature,particularly happening in male patients.CASE SUMMARY We report here a Crohn´s disease patient presenting with de novo hypergammaglobulinemia,circulating autoantibodies and elevated transaminase levels.He also had significant peripheral eosinophilia and elevated immunoglobulin E levels at diagnosis.The pathology findings from liver biopsy were compatible with autoimmune hepatitis with eosinophilic infiltration.CONCLUSION This is the first report of autoimmune hepatitis with exuberant eosinophilic infiltration in the liver and bone marrow,described in a patient with Crohn’s disease.

关键词： autoimmune hepatitis Eosinophilia Bone marrow Crohn’s disease Case report

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

TOX deficiency facilitates the differentiation of IL-17A-producingγδT cells to drive autoimmune hepatitis

引用

Cellular & Molecular Immunology 2022年第10期19卷 1102-1116页

作者： Qifeng He Yijun Lu Wenfang Tian Runqiu Jiang Weiwei Yu Yong Liu Meiling Sun Fei Wang Haitian Zhang Ning Wu Zhongjun Dong Beicheng Sun Department of Hepatobiliary Surgery Affiliated Drum Tower HospitalMedical School of Nanjing UniversityNanjingChina Department of Hepatobiliary Surgery The First Affiliated Hospital of Anhui Medical UniversityHefeiChina

The specification of theαβ/γδlineage and the maturation of medullary thymic epithelial cells(mTECs)coordinate central tolerance to self-antigens.However,the mechanisms underlying this biological process remain poorly clarified.Here,we report that dual-stage loss of TOX in thymocytes hierarchically impaired mTEC maturation,promoted thymic IL-17A-producingγδT-cell(Tγδ17)lineage commitment,and led to the development of fatal autoimmune hepatitis(AIH)via different mechanisms.Transfer ofγδT cells from TOX-deficient mice reproduced AIH.TOX interacted with and stabilized the TCF1 protein to maintain the balance ofγδT-cell development in thymic progenitors,and overexpression of TCF1 normalizedαβ/γδlineage specification and activation.In addition,TOX expression was downregulated inγδT cells from AIH patients and was inversely correlated with the AIH diagnostic score.Our findings suggest multifaceted roles of TOX in autoimmune control involving mTEC and Tγδ17 development and provide a potential diagnostic marker for AIH.

关键词： autoimmune hepatitis γδT cell IL-17A Immune tolerance TOX

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：