Autoimmune hepatitis natural history, complications and prognosis: Difference between revisions
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*Prognosis is generally excellent, and the 10-year survival rate of patients with Autoimmune hepatitis treated with immunosuppressive therapy is approximately 80%.<ref name="pmid21396370">{{cite journal |vauthors=Hoeroldt B, McFarlane E, Dube A, Basumani P, Karajeh M, Campbell MJ, Gleeson D |title=Long-term outcomes of patients with autoimmune hepatitis managed at a nontransplant center |journal=Gastroenterology |volume=140 |issue=7 |pages=1980–9 |year=2011 |pmid=21396370 |doi=10.1053/j.gastro.2011.02.065 |url=}}</ref><ref name="pmid16298014">{{cite journal |vauthors=D'Amico G, Garcia-Tsao G, Pagliaro L |title=Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies |journal=J. Hepatol. |volume=44 |issue=1 |pages=217–31 |year=2006 |pmid=16298014 |doi=10.1016/j.jhep.2005.10.013 |url=}}</ref> | *Prognosis is generally excellent, and the 10-year survival rate of patients with Autoimmune hepatitis treated with immunosuppressive therapy is approximately 80%.<ref name="pmid21396370">{{cite journal |vauthors=Hoeroldt B, McFarlane E, Dube A, Basumani P, Karajeh M, Campbell MJ, Gleeson D |title=Long-term outcomes of patients with autoimmune hepatitis managed at a nontransplant center |journal=Gastroenterology |volume=140 |issue=7 |pages=1980–9 |year=2011 |pmid=21396370 |doi=10.1053/j.gastro.2011.02.065 |url=}}</ref><ref name="pmid16298014">{{cite journal |vauthors=D'Amico G, Garcia-Tsao G, Pagliaro L |title=Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies |journal=J. Hepatol. |volume=44 |issue=1 |pages=217–31 |year=2006 |pmid=16298014 |doi=10.1016/j.jhep.2005.10.013 |url=}}</ref> | ||
*Prognosis is bad without treatment, 50% of patients with severe autoimmune hepatitis will die in a 5 years, and 80-90% of patients will die within 10 years of disease onset. | *Prognosis is bad without treatment, 50% of patients with severe autoimmune hepatitis will die in a 5 years, and 80-90% of patients will die within 10 years of disease onset. | ||
* | *The presence of Young age at presentation, AIH-2, Coagulopathy, Severe initial histologic activity is associated with a poor prognosis among patients with Autoimmune hepatitis. | ||
==References== | ==References== | ||
Revision as of 03:06, 28 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: :Manpreet Kaur, MD [2]
Overview
Natural History
- The symptoms of Autoimmune hepatitis usually has a bimodal age distribution, with a first peak of incidence at age 10-20 years and a second at age 45-70 years of life, and starts with asymptomatic progresses to acute liver failure.[1]
- If left untreated, patients with Autoimmune hepatitis may progress to develop Cirrhosis, and Portal hypertension.
Complications
Common complications of Autoimmune hepatitis include:[2][3]
- Cirrhosis and complications of cirrhosis:
- Portal hypertension
- Esophageal varices
- Metabolic bone disease
- Hyperlipidaemia
- Hypovitaminosis
- Cholestasis
- Pruritis
Prognosis
- Prognosis is generally excellent, and the 10-year survival rate of patients with Autoimmune hepatitis treated with immunosuppressive therapy is approximately 80%.[4][5]
- Prognosis is bad without treatment, 50% of patients with severe autoimmune hepatitis will die in a 5 years, and 80-90% of patients will die within 10 years of disease onset.
- The presence of Young age at presentation, AIH-2, Coagulopathy, Severe initial histologic activity is associated with a poor prognosis among patients with Autoimmune hepatitis.
References
- ↑ Sonthalia N, Rathi PM, Jain SS, Surude RG, Mohite AR, Pawar SV, Contractor Q (2017). "Natural History and Treatment Outcomes of Severe Autoimmune Hepatitis". J. Clin. Gastroenterol. 51 (6): 548–556. doi:10.1097/MCG.0000000000000805. PMID 28272079.
- ↑ Trivedi PJ, Hirschfield GM (2013). "Treatment of autoimmune liver disease: current and future therapeutic options". Ther Adv Chronic Dis. 4 (3): 119–41. doi:10.1177/2040622313478646. PMC 3629750. PMID 23634279.
- ↑ Gleeson D, Heneghan MA (2011). "British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis". Gut. 60 (12): 1611–29. doi:10.1136/gut.2010.235259. PMID 21757447.
- ↑ Hoeroldt B, McFarlane E, Dube A, Basumani P, Karajeh M, Campbell MJ, Gleeson D (2011). "Long-term outcomes of patients with autoimmune hepatitis managed at a nontransplant center". Gastroenterology. 140 (7): 1980–9. doi:10.1053/j.gastro.2011.02.065. PMID 21396370.
- ↑ D'Amico G, Garcia-Tsao G, Pagliaro L (2006). "Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies". J. Hepatol. 44 (1): 217–31. doi:10.1016/j.jhep.2005.10.013. PMID 16298014.