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Autoimmune hepatitis with incidental histologic features of bile duct injury
Open accessAbstract
Bile duct changes are atypical of autoimmune hepatitis. Our aims were to assess the frequency and significance of these changes in classical disease. Liver biopsy specimens were reviewed under code from 84 patients who satisfied international scoring criteria for autoimmune hepatitis, and the findings were correlated with clinical features and outcome. Twenty patients (24%) had biliary changes, including 6 with destructive cholangitis, 4 with ductopenia, and 10 with nondestructive cholangitis. Patients with and without bile duct changes had similar laboratory findings. Diagnostic scores for autoimmune hepatitis were lower in patients with bile duct changes (16.6 ± 0.6 vs. 19.1 ± 0.2, P < .0001). The frequencies of scores sufficient for a definite (80% vs. 97%, P = .03) or probable diagnosis (20% vs. 3%, P = .03) were also less in this group. Patients with destructive cholangitis and/or ductopenia responded as well to therapy as patients with nondestructive cholangitis, and outcomes in each group were similar to those of patients without biliary changes. We concluded that biliary changes can occur in classic autoimmune hepatitis, and they are not associated with distinctive clinical features or treatment response. They may be coincidental findings associated with classic disease or weak expressions of a variant syndrome. In the absence of a cholestatic clinical syndrome, they do not compel a different management strategy.
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“as well as that acute AIH may be associated with considerable bile duct damage [170].”
From EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis. (2017) · cites this paper as [170]
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“AMA may be present in patients with acute hepatitis, with titres usually decreasing over time;”
From EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary biliary cholangitis. (2017) · cites this paper as [170]
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Metadata
- Authors
- Czaja, A. J., & Carpenter, H. A.
- Affiliations
- Mayo Clinic (US)
- Corresponding author
- Czaja, Albert J.
- ORCID
- Czaja, Albert J.
- Venue
- Hepatology
- Published
- 2001-10
- Volume
- 34
- Issue
- 4
- Pages
- 659-665
- ISSN
- 0270-9139 (ISSN-L)
- OpenAlex
- W2095515459
- Semantic Scholar
- 9a8a164f90e4ec1627abaf299b760e0935168d5c
- Cited by
- 189
- References
- 47
- Citations by year
- 2025: 5 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 6 · 2020: 10 · 2019: 4 · 2018: 7 · 2017: 9 · 2016: 7 · 2015: 6 · 2014: 6 · 2013: 11 · 2012: 10
- FWCI
- 5.71
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Rheumatology › IgG4-Related and Inflammatory Diseases
- Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
- Keywords
- autoimmune hepatitis, bile duct injury, cholangitis, ductopenia, liver biopsy histology, treatment response, clinical outcomes, cholestatic syndrome
- MeSH terms
- Adolescent, Adult, Aged, Bile Ducts, Cholangitis, Female, Humans, Male, Middle Aged, Treatment Outcome, Hepatitis, Autoimmune
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