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Alcoholic liver disease and autoimmune hepatitis: Sometimes a closer look under the surface is needed
dc.creator | Rigopoulou E.I., Gatselis N., Arvaniti P., Koukoulis G.K., Dalekos G.N. | en |
dc.date.accessioned | 2023-01-31T09:51:30Z | |
dc.date.available | 2023-01-31T09:51:30Z | |
dc.date.issued | 2021 | |
dc.identifier | 10.1016/j.ejim.2020.12.024 | |
dc.identifier.issn | 09536205 | |
dc.identifier.uri | http://hdl.handle.net/11615/78508 | |
dc.description.abstract | Aims: Differential diagnosis of autoimmune hepatitis (AIH) incorporates various liver diseases, including alcoholic liver disease (ALD). We report on clinical, laboratory and outcome characteristics of AIH patients who were initially referred as ALD based on increased alcohol consumption (AIH/ALD). Methods: From 2000-2019, we retrospectively identified 12 AIH/ALD patients [9 males, age: 61 (30-73) years] in our prospective data base of 317 AIH patients. Results: AIH diagnosis was based on aminotransferases elevation in 10 patients, high IgG in 8, compatible autoantibody profile in all and typical/compatible histology in all 9 with available biopsy. There were no significant differences of baseline demographics, presentation, cirrhosis at diagnosis, response to treatment and simplified score compared to 45 age- and sex-matched AIH patients without alcohol consumption and 44 age- and sex-matched ALD patients. However, the AIH/ALD cohort was characterized by more frequent progression to cirrhosis, higher liver-related deaths and overall mortality compared to AIH, though similar to the ALD group. AST/ALT ratio>1 seems to bear a good positive (0.84) and negative predictive value (0.88) for ALD and AIH diagnosis, respectively, but cannot help in discriminating the AIH/ALD variant. Conclusions: AIH should not be forgotten in patients with alcohol use when clinical and laboratory features hint towards the diagnosis of AIH/ALD variant as this group seems to have worse outcome compared to those with AIH alone suggesting the need for closer follow-up and surveillance. Reliable autoantibody testing and cautious interpretation of liver histology appear mandatory for AIH diagnosis in these difficult to diagnose cases. © 2021 | en |
dc.language.iso | en | en |
dc.source | European Journal of Internal Medicine | en |
dc.source.uri | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85100178503&doi=10.1016%2fj.ejim.2020.12.024&partnerID=40&md5=02523a6213daaff1442fc38acae0a04d | |
dc.subject | alanine aminotransferase | en |
dc.subject | aspartate aminotransferase | en |
dc.subject | autoantibody | en |
dc.subject | azathioprine | en |
dc.subject | immunoglobulin G | en |
dc.subject | mycophenolate mofetil | en |
dc.subject | prednisolone | en |
dc.subject | adult | en |
dc.subject | aged | en |
dc.subject | alanine aminotransferase blood level | en |
dc.subject | alcohol consumption | en |
dc.subject | alcohol liver disease | en |
dc.subject | antibody titer | en |
dc.subject | Article | en |
dc.subject | aspartate aminotransferase blood level | en |
dc.subject | autoimmune hepatitis | en |
dc.subject | clinical article | en |
dc.subject | controlled study | en |
dc.subject | data analysis software | en |
dc.subject | diagnostic test accuracy study | en |
dc.subject | disease severity | en |
dc.subject | drug withdrawal | en |
dc.subject | female | en |
dc.subject | follow up | en |
dc.subject | human | en |
dc.subject | human tissue | en |
dc.subject | idiopathic thrombocytopenic purpura | en |
dc.subject | immunoglobulin blood level | en |
dc.subject | immunosuppressive treatment | en |
dc.subject | liver biopsy | en |
dc.subject | male | en |
dc.subject | predictive value | en |
dc.subject | retrospective study | en |
dc.subject | thrombocytopenia | en |
dc.subject | treatment response | en |
dc.subject | unspecified side effect | en |
dc.subject | alcohol liver disease | en |
dc.subject | autoimmune hepatitis | en |
dc.subject | liver | en |
dc.subject | middle aged | en |
dc.subject | prospective study | en |
dc.subject | Hepatitis, Autoimmune | en |
dc.subject | Humans | en |
dc.subject | Liver | en |
dc.subject | Liver Diseases, Alcoholic | en |
dc.subject | Male | en |
dc.subject | Middle Aged | en |
dc.subject | Prospective Studies | en |
dc.subject | Retrospective Studies | en |
dc.subject | Elsevier B.V. | en |
dc.title | Alcoholic liver disease and autoimmune hepatitis: Sometimes a closer look under the surface is needed | en |
dc.type | journalArticle | en |
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