Diagnosis and treatment of autoimmune hepatitis

被引：27
作者：
John M. Vierling
机构：
[1] Liver Center, Baylor College of Medicine, St. Luke's Episcopal Hospital, Houston, TX 77030
来源：
Current Gastroenterology Reports | 2012年 / 14卷 / 1期
关键词：
Associated immunological diseases; Autoantibodies; Autoimmune hepatitis; Diagnosis; Drug-induced liver injury; Hepatocellular carcinoma; Immunosuppression; Liver transplantation; Outcomes; Therapy;
D O I：
10.1007/s11894-011-0236-2
中图分类号：
学科分类号：
摘要：
Autoimmune hepatitis is a chronic liver disease characterized by elevated aminotransferase levels, autoantibodies, increased γ-globulin or IgG levels and biopsy evidence of interface hepatitis. Recent advances include new practice guidelines that redefine criteria for remission to require complete biochemical and histological normalization on therapy; comparisons between the revised original and simplified diagnostic scoring systems; refined characterization of autoantibodies and their diagnostic performance parameters; proof of the safety and efficacy of combination budesonide and azathioprine therapy for non-cirrhotic patients; scrutiny of overlap syndromes; further analyses of the outcomes of orthotopic liver transplantation and the diagnosis and treatment of recurrent and de novo autoimmune hepatitis after transplantation. Anticipated consequences of the application of the new definition of therapeutic remission include a reduction in the proportion of patients achieving remission with conventional immunosuppression regimens and a corresponding increase in the need for alternative therapies. © 2011 Springer Science+Business Media, LLC.
引用
收藏
页码：25 / 36
页数：11
相关论文
共 97 条
  • [41] Bjornsson E., Talwalkar J., Treeprasertsuk S., Et al., Drug-induced autoimmune hepatitis: Clinical characteristics and prognosis, Hepatology, 51, pp. 2040-2048, (2010)
  • [42] Peedikayil M.C., Dahhan T.I., Al Ashgar H.I., Nitrofurantoin-induced fulminant hepatitis mimicking autoimmune hepatitis [2], Annals of Pharmacotherapy, 40, 10, pp. 1888-1889, (2006)
  • [43] Alla V., Abraham J., Siddiqui J., Raina D., Wu G.Y., Chalasani N.P., Bonkovsky H.L., Autoimmune hepatitis triggered by statins, Journal of Clinical Gastroenterology, 40, 8, pp. 757-761, (2006)
  • [44] Castiella A., Fernandez J., Zapata E., Autoimmune hepatitis after treatment with fluvastatin, Liver International, 27, 4, (2007)
  • [45] Pelli N., Setti M., Atorvastatin as a trigger of autoimmune hepatitis [2], Journal of Hepatology, 40, 4, (2004)
  • [46] Russo M.W., Scobey M., Bonkovsky H.L., Drug-induced liver injury associated with statins, Semin Liver Dis, 29, pp. 412-422, (2009)
  • [47] Wolters L.M.M., Van Buuren H.R., Rosuvastatin-associated hepatitis with autoimmune features, European Journal of Gastroenterology and Hepatology, 17, 5, pp. 589-590, (2005)
  • [48] Khokhar O.S., Lewis J.H., Hepatotoxicity of agents used in the management of inflammatory bowel disease, Dig Dis, 28, pp. 508-518, (2010)
  • [49] Cravo M., Silva R., Serrano M., Autoimmune hepatitis induced by infliximab in a patient with Crohn's disease with no relapse after switching to adalimumab, BioDrugs, 24, SUPPL. 1, pp. 25-27, (2010)
  • [50] Mancini S., Amorotti E., Vecchio S., Et al., Infliximab-related hepatitis: Discussion of a case and review of the literature, Intern Emerg Med, 5, pp. 193-200, (2010)
12345678910