Original article—liver, pancreas, and biliary tractEffects of Serum Aspartate Aminotransferase Levels in Patients With Autoimmune Hepatitis Influence Disease Course and Outcome
Section snippets
Patients
The records of 235 patients with definite AIH, classified according to the revised criteria of the International AIH Group (IAIHG) (median IAIHG score, 22; range, 16–28),4 presenting in adult hepatology clinics between 1971 and 2005, were examined retrospectively. All patients were seronegative for viral hepatitis as determined by tests for hepatitis B surface antigen and hepatitis C virus antibody, including retrospective testing for anti–hepatitis C virus of stored sera from patients who
Demographics and Biochemical Parameters
Patient demographics are summarized in Table 1. Age at diagnosis, sex distribution, and duration of follow-up period were not significantly different between the 3 groups. Patients with an AST level of less than 10× UPLN at presentation were significantly more likely to be asymptomatic (P < .001) and took significantly longer to be diagnosed with AIH than patients presenting with an AST level of greater than 10× UPLN (median time to diagnosis in groups 1 and 2, 6 mo; vs median time to diagnosis
Discussion
Serum aminotransferase activity at presentation represents an important marker of inflammation in patients with AIH. In this study we have investigated the long-term outcome of patients who present with different levels of increases in AST and identified that an AST level less than 10 times the UPLN at presentation was associated with reduced long-term survival, and, in addition, this group of patients presented more frequently with clinical and histologic evidence of cirrhosis. Moreover,
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Aminotransferases During Treatment Predict Long-Term Survival in Patients With Autoimmune Hepatitis Type 1: A Landmark Analysis
2022, Clinical Gastroenterology and HepatologyCitation Excerpt :In the current study a doubling of AST at diagnosis resulted in 27% decrease in HR. Patients with high levels of aminotransferases at diagnosis more often have symptoms and less often have decompensated cirrhosis.28 The increased rate of symptoms could lead to earlier diagnosis and treatment.
B-cell activating factor and IL-21 levels predict treatment response in autoimmune hepatitis
2022, JHEP ReportsCitation Excerpt :Patients with high BAFF had the best treatment response with the highest remission rate and the lowest level of aminotransferases at 12 months. Previously high aminotransferases at diagnosis were reported to be correlated with a better long-term survival.20 Fast decrease of aminotransferases during treatment and complete biochemical remission at 12 months were also associated with a better long-term survival.21
Non-invasive diagnosis and follow-up of autoimmune hepatitis
2022, Clinics and Research in Hepatology and GastroenterologyRapid Response to Treatment of Autoimmune Hepatitis Associated With Remission at 6 and 12 Months
2020, Clinical Gastroenterology and HepatologyCitation Excerpt :However, the concept of rapidity of treatment response and its consequences has been largely unexplored. Results of our study accord with those of The King’s College group who described an association between baseline AST levels and cirrhosis development and long-term outcome.5 Patients with AST levels at diagnosis less than 10 times ULN had a higher risk on liver transplantation or death.
The management of childhood liver diseases in adulthood
2017, Journal of HepatologyCitation Excerpt :The remaining patients often present insidiously, with more subtle symptoms of weight loss, anorexia, malaise occurring over many years. The presentation in adults is similar and varies from mild biochemical abnormalities to sub-acute liver failure [93]. Differences in autoimmune liver disease between children and adults is summarised in Table 5.
Prognosis of acute severe autoimmune hepatitis (AS-AIH): The role of corticosteroids in modifying outcome
2014, Journal of HepatologyCitation Excerpt :In addition the absence of chronic liver disease on histological evaluation was a pre-requisite for a diagnosis of AS-AIH. The serum level of AST was not used as a marker of disease severity in this cohort as previous work from this institution has shown that those with a higher AST have a better prognosis [18] and also that, in acute disease, the early fall in AST post treatment does not adequately predict treatment responsiveness [19]. The model for end stage liver disease (MELD) score was originally developed to predict poor outcomes following trans-jugular intra-hepatic porto-systemic shunts (TIPSS) [20].
The authors disclose no conflicts.