Autoimmune acute liver failure: Proposed clinical and histological criteria
dc.contributor.author | Stravitz, R. Todd | en_US |
dc.contributor.author | Lefkowitch, Jay H. | en_US |
dc.contributor.author | Fontana, Robert John | en_US |
dc.contributor.author | Gershwin, M. Eric | en_US |
dc.contributor.author | Leung, Patrick S. C. | en_US |
dc.contributor.author | Sterling, Richard K. | en_US |
dc.contributor.author | Manns, Michael P. | en_US |
dc.contributor.author | Norman, Gary L. | en_US |
dc.contributor.author | Lee, William M. | en_US |
dc.date.accessioned | 2011-02-02T17:57:59Z | |
dc.date.available | 2012-03-05T15:30:01Z | en_US |
dc.date.issued | 2011-02 | en_US |
dc.identifier.citation | Stravitz, R. Todd; Lefkowitch, Jay H.; Fontana, Robert J.; Gershwin, M. Eric; Leung, Patrick S. C.; Sterling, Richard K.; Manns, Michael P.; Norman, Gary L.; Lee, William M. (2011). "Autoimmune acute liver failure: Proposed clinical and histological criteria" Hepatology 53(2): 517-526. <http://hdl.handle.net/2027.42/79410> | en_US |
dc.identifier.issn | 0270-9139 | en_US |
dc.identifier.issn | 1527-3350 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/79410 | |
dc.description.abstract | Identifying autoimmune hepatitis as the etiology of acute liver failure (ALF) is potentially important, because administering corticosteroids might avoid the need for liver transplantation. However, clinical and histological criteria of autoimmune ALF (AI-ALF) have not been defined. Liver sections (biopsies and explants) from a 72-patient subset of the ALF Study Group Registry with indeterminate ALF were reviewed by a pathologist blinded to all clinical data and were diagnosed with probable AI-ALF based on four features suggestive of an autoi mmune pathogenesis: distinctive patterns of massive hepatic necrosis (present in 42% of sections), presence of lymphoid follicles (32%), a plasma cell–enriched inflammatory infiltrate (63%), and central perivenulitis (65%). Forty-two sections (58%) were considered probable for AI-ALF; this group demonstrated higher serum globulins (3.7 ± 0.2 g/dL versus 3.0 ± 0.2 g/dL; P = 0.037) and a higher prevalence of antinuclear and/or anti–smooth muscle antibodies (73% versus 48%; P = 0.034) compared to those without histology suggestive of probable AI-ALF. Thirty patients concordant for autoantibodies and probable AI-ALF upon histological analysis were more likely to have the classical autoimmune hepatitis phenotype (female predominance [72% versus 48%; P < 0.05], higher globulins [3.9 ± 0.2 g/dL versus 3.0 ± 0.2 g/dL; P < 0.005], and higher incidence of chronic hepatitis in long-term follow-up [67% versus 17%, P = 0.019]) compared to the population without concordant AI-ALF histology and autoantibodies. Conclusion: Patients with indeterminate ALF often have features of autoimmune disease by histological analysis, serological testing, and clinical recurrence during follow-up. In contrast to classical autoimmune hepatitis, histological features of AI-ALF predominate in the centrilobular zone. (H EPATOLOGY 2011;53:517-526) | en_US |
dc.format.extent | 623356 bytes | |
dc.format.extent | 3118 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Wiley Subscription Services, Inc., A Wiley Company | en_US |
dc.subject.other | Life and Medical Sciences | en_US |
dc.subject.other | Hepatology | en_US |
dc.title | Autoimmune acute liver failure: Proposed clinical and histological criteria | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Division of Gastroenterology, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationother | Section of Hepatology, Virginia Commonwealth University, Richmond, VA ; These authors contributed equally to this work. ; fax: 804-828-4945 ; Section of Hepatology, Hume-Lee Transplant Center, Virginia Commonwealth University, P.O. Box 980341, Richmond, VA 23298-0341 | en_US |
dc.contributor.affiliationother | Department of Pathology, Columbia University, New York, NY | en_US |
dc.contributor.affiliationother | Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis, Davis, CA | en_US |
dc.contributor.affiliationother | Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis, Davis, CA | en_US |
dc.contributor.affiliationother | Section of Hepatology, Virginia Commonwealth University, Richmond, VA | en_US |
dc.contributor.affiliationother | Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Hannover, Germany | en_US |
dc.contributor.affiliationother | INOVA Diagnostics, Inc., San Diego, CA | en_US |
dc.contributor.affiliationother | Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX | en_US |
dc.identifier.pmid | 21274872 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/79410/1/24080_ftp.pdf | |
dc.identifier.doi | 10.1002/hep.24080 | en_US |
dc.identifier.source | Hepatology | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
Files in this item
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.