2.Clinical features of 107 autoimmune hepatitis patients and 30 of them with AIH-primary biliary cirrhosis overlap syndrome.
De-kai QIU ; Xin-min LI ; Jue WEI ; Li-jing YE ; Yan-shen PENG ; Xiong MA
Chinese Journal of Hepatology 2008;16(5):367-371
OBJECTIVEIn order to provide a reliable basis for the diagnosis and treatment of autoimmune hepatitis (AIH) and its overlap syndrome, we investigated the clinical, immunological characteristics of and the therapeutic methods for AIH and AIH-primary biliary cirrhosis (PBC) overlap syndrome.
METHODSOne hundred seven patients (77 with AIH and 30 with AIH-PBC overlap syndrome) were enrolled in the study. Their clinical manifestations, serum liver function tests (LFTs) findings, serum immunoglobulins, liver histopathological changes and their responsiveness to the therapies were investigated.
RESULTSThe age distribution of AIH patients showed a single peak during their fifties and their main clinical manifestations were malaise, abdominal distension, anorexia and jaundice. Serum gamma globulin and IgG were significantly higher than their normal levels. 74% of the patients were positive for anti-nuclear antibody (ANA), 32% of the patients were positive for anti-smooth muscle antibody (AMA), and over 50% of the patients suffered from concurrent extrahepatic autoimmune diseases. The main histological changes in the liver biopsies were interface hepatitis (65%), lobular hepatitis and rosette formation of liver cells. Bridging necrosis was observed in severe AIH cases. In the AIH-PBC overlap syndrome patients, the levels of serum ALT, AST, GGT, ALP and incidences of ANA and AMA/AMA-M2 were all significantly higher than those of the AIH group. After treating AIH patients with prednisolone and azathioprine (Aza), complete response was seen in 42 cases (70%), sustained response was seen in 26 cases (43%). Sixteen cases had relapses after the withdrawal of the treatment or prednisolone dosage was reduced lower than 10 mg/d. The cases having normal serum ALT, AST, gamma-globulin and IgG levels after treatment were still responding to the reduced prednisolone dosage of 5-10 mg/d without azathioprine added. After combination with ursodeoxycholic acid (UDCA) treatment, the liver function tests (AST, ALT, TBil) of AIH-PBC overlap syndrome patients also significantly improved compared to those before the treatment (P<0.01).
CONCLUSIONAIH and AIH-PBC overlap syndrome are not rare in our clinics. Their diagnoses should be based on the clinical presentations, biochemical and immunological indices and liver histological changes. In AIH cases, once their AST, ALT, gamma-globulin and IgG levels return to normal, the prednisolone dosage can be maintained at 5-10 mg/d and Aza can even be withdrawn. Good improvement for patients with AIH-PBC overlap syndrome can be obtained with UDCA and immunosuppression treatment.
Female ; Hepatitis, Autoimmune ; diagnosis ; drug therapy ; Humans ; Liver Cirrhosis, Biliary ; diagnosis ; drug therapy ; Male ; Middle Aged ; Prognosis ; Syndrome
3.Statins in chronic liver diseases: safety and effect.
Chinese Journal of Hepatology 2010;18(6):478-480
4.Effect of post-liver transplantation administration of ursodeoxycholic acid on serum liver tests and biliary complications: a randomized clinical trial.
Shuyun WANG ; Meihua TANG ; Guoqing CHEN ; Junming XU ; Lin ZHONG ; Zhaowen WANG ; Guilong DENG ; Tonghai XING ; Lungen LU ; Zhihai PENG
Chinese Journal of Hepatology 2014;22(7):529-535
OBJECTIVEEndogenous hydrophobic bile acids may be a pathogenetic factor of biliary complications after orthotopic liver transplantation (OLT).This study was designed to investigate the effects of hydrophilic ursodeoxycholic acid (UDCA), when administered early after OLT, on serum liver tests and on the incidence of biliary complications.
METHODSA total of 112 adult patients undergoing OLT were randomly assigned to one of two groups for receipt of UDCA (13 to 15 mg/kg/d for 4 weeks, n=56) or a placebo (n=56). All patients underwent serum liver testing and measurement of serum bile acids during the 4 weeks following OLT.Patients with T-tube underwent measurement of biliary bile acids during the 4 weeks following OLT.Biliary complications, as well as patient and graft survival rates, were analyzed during the follow-up period (mean of 65.6 months).
RESULTSAt post-OLT days 7, 21 and 28, the UDCA-treated patients showed significantly lower levels of alanine aminotransferase, aspartate aminotransferase and gamma glutamyl transpeptidase (all P less than 0.05).In addition, the UDCA-treated patients showed significantly lower incidence of biliary sludge and casts within the first year post-OLT (3.6% vs.14.3%; x2=3.953, P=0.047). However, there were no significant differences for the incidence of other biliary complications at post-OLT years 1, 3 and 5.The graft and patient survival rates were also similar between the two groups.
CONCLUSIONUDCA, when administered early after OLT, improves results from serum liver tests and decreases the incidence of biliary sludge and casts within the first postoperative year.
Alanine Transaminase ; Aspartate Aminotransferases ; Bile ; Bile Acids and Salts ; Biliary Tract Diseases ; drug therapy ; physiopathology ; Humans ; Liver ; physiopathology ; Liver Cirrhosis, Biliary ; Liver Function Tests ; Liver Transplantation ; Postoperative Complications ; physiopathology ; Ursodeoxycholic Acid ; therapeutic use ; gamma-Glutamyltransferase
5.Clinical features of the overlap syndrome of autoimmune hepatitis and primary biliary cirrhosis: retrospective study.
Chi-hong WU ; Qin-huan WANG ; Geng-shan TIAN ; Xiao-yuan XU ; Yan-yan YU ; Gui-qiang WANG
Chinese Medical Journal 2006;119(3):238-241
Adult
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Aged
;
Female
;
Hepatitis, Autoimmune
;
blood
;
complications
;
drug therapy
;
pathology
;
Humans
;
Liver Cirrhosis, Biliary
;
blood
;
complications
;
drug therapy
;
pathology
;
Male
;
Middle Aged
;
Retrospective Studies
6.Revision and update on clinical practice guideline for liver cirrhosis.
Ki Tae SUK ; Soon Koo BAIK ; Jung Hwan YOON ; Jae Youn CHEONG ; Yong Han PAIK ; Chang Hyeong LEE ; Young Seok KIM ; Jin Woo LEE ; Dong Joon KIM ; Sung Won CHO ; Seong Gyu HWANG ; Joo Hyun SOHN ; Moon Young KIM ; Young Bae KIM ; Jae Geun KIM ; Yong Kyun CHO ; Moon Seok CHOI ; Hyung Joon KIM ; Hyun Woong LEE ; Seung Up KIM ; Ja Kyung KIM ; Jin Young CHOI ; Dae Won JUN ; Won Young TAK ; Byung Seok LEE ; Byoung Kuk JANG ; Woo Jin CHUNG ; Hong Soo KIM ; Jae Young JANG ; Soung Won JEONG ; Sang Gyune KIM ; Oh Sang KWON ; Young Kul JUNG ; Won Hyeok CHOE ; June Sung LEE ; In Hee KIM ; Jae Jun SHIM ; Gab Jin CHEON ; Si Hyun BAE ; Yeon Seok SEO ; Dae Hee CHOI ; Se Jin JANG
The Korean Journal of Hepatology 2012;18(1):1-21
No abstract available.
Antiviral Agents/therapeutic use
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Ascites/diagnosis/prevention & control/therapy
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Cholagogues and Choleretics/therapeutic use
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Fatty Liver/diagnosis/diet therapy
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Fatty Liver, Alcoholic/diagnosis/drug therapy
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Hemorrhage/prevention & control/therapy
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Hepatic Encephalopathy/diagnosis/prevention & control/therapy
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Hepatitis B, Chronic/diagnosis/drug therapy
;
Hepatitis C, Chronic/diagnosis/drug therapy
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Humans
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Liver Cirrhosis/*diagnosis/drug therapy/pathology/*therapy
;
Liver Cirrhosis, Biliary/drug therapy
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Vasodilator Agents/therapeutic use
8.Treatment of early and mid-term primary biliary cirrhosis by Qingying Huoxue Decoction Combined ursodeoxycholic acid: a clinical observation.
De-Cai FU ; Zong HUA ; Yi-Guang LI ; Hang-Yuan WU ; Xiao-Ye GUO ; Jian-Zhong HUANG
Chinese Journal of Integrated Traditional and Western Medicine 2015;35(3):290-293
UNLABELLEDOBJECTIVE To observe the clinical efficacy by Qingying Huoxue Decoction (QHD) combined ursodeoxycholic acid (UDCA) in treating patients with early and mid-term primary biliary cirrhosis (PBC). METHODS Totally 78 patients were randomly assigned to the treatment group and the control group, 39 in each group. All patients received basic treatment and took UDCA (at the daily dose of 13-15 mg/kg). Patients in the treatment group took QHD, one dose per day. The treatment course for all was 6 weeks. Clinical efficacy, gamma-glutamyl transferase (γ-GGT), alkaline phospatase (ALP), TBIL, alanine aminotransferase (ALT), and aspartate transaminase (AST) were observed before and after treatment. RESULTS Totally 21 (53. 8%) patients obtained complete response in the treatment group, with statistical difference when compared with that of the control group (11 cases, 30. 8%). Levels of GGT, ALP, ALT, AST, and TBIL decreased in the two groups after treatment (P < 0.01). Levels of ALP, GGT, and TBIL were obviously lower in the treatment group than in the control group (P < 0.05).
CONCLUSIONSQHD combined UDCA in treating early and mid-term PBC patients was superior to the effect of using UDCA alone. It also could improve patients' liver function.
Alanine Transaminase ; metabolism ; Aspartate Aminotransferases ; metabolism ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Liver Cirrhosis, Biliary ; drug therapy ; Ursodeoxycholic Acid ; therapeutic use ; gamma-Glutamyltransferase ; metabolism
9.Pathologic diagnosis of autoimmune liver disease.
Chinese Journal of Pathology 2007;36(11):772-776
Autoimmune Diseases
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drug therapy
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pathology
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Cholangitis
;
drug therapy
;
immunology
;
pathology
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Cholangitis, Sclerosing
;
drug therapy
;
immunology
;
pathology
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Hepatitis, Autoimmune
;
drug therapy
;
immunology
;
pathology
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Humans
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Interferon-gamma
;
therapeutic use
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Liver Cirrhosis, Biliary
;
drug therapy
;
immunology
;
pathology
;
Ursodeoxycholic Acid
;
therapeutic use