Clinicopathological features of acute-onset autoimmune hepatitis |
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| Affiliation: | 1. Departamento de Química Analítica, Química Física e Ingeniería Química, Universidad de Alcalá, Ctra. Madrid-Barcelona Km. 33.600, Alcalá de Henares, 28871 Madrid, Spain;2. Centro de Espectroscopía de Resonancia Magnética Nuclear (CERMN), Centro de Apoyo a la Investigación en Química, Universidad de Alcalá, Ctra. Madrid-Barcelona Km. 33.600, Alcalá de Henares, 28871 Madrid, Spain;1. Department of Pathology, Microbiology & Immunology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA;2. Veterans Administration Tennessee Valley Healthcare System, Nashville, TN 37332, USA;3. Department of Pediatrics, University of Pittsburgh School of Medicine, Children''s Hospital of Pittsburgh of University of Pittsburgh Medical Center, USA;1. Division of Physiology and Climatology, ICAR – Indian Veterinary Research Institute, Izatnagar, UP-243122, India;2. Division of Surgery, ICAR – Indian Veterinary Research Institute, Izatnagar, UP-243122, India;3. Biochemistry and Food Science Section, ICAR – Indian Veterinary Research Institute, Izatnagar, UP-243122, India;4. Biophysics, Electron Microscopy and Instrumentation Section, ICAR – Indian Veterinary Research Institute, Izatnagar, UP-243122, India;5. Division of Livestock Economics, Statistics and Information Technology, ICAR – Indian Veterinary Research Institute, Izatnagar, UP-243122, India;1. Department of Radiology, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi 110027, India;2. Department of Hepatology and Gastroenterology, Centre for Liver & Biliary Sciences, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi 110027, India;3. Department of Liver Transplant Surgery, Centre for Liver and Biliary Sciences, Indraprastha Apollo Hospital, New Delhi, India |
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| Abstract: | The clinicopathological features of nine acute-onset autoimmune hepatitis (AIH) patients were compared with those of 29 classical AIH patients. The clinical features of acute-onset AIH showed significantly higher serum ALT levels, lower serum IgG levels and AIH score than those of classical AIH, although the type of auto-antibodies, age and gender were not different between the two groups. Pathological features showed that the stages of acute-onset AIH varied from stage 1 to stage 4 and were less advanced compared with those of classical AIH. One patient showed submassive hepatic necrosis. Both centrilobular necrosis and interface hepatitis were observed in 7 and 8 of 9, respectively. Three stage 1 patients with centrilobular necrosis and one patient with submassive hepatic necrosis were suggestive of acute presentation, while patients with stages 2 and 4 fibrosis were suggestive of acute exacerbation of chronic disease. An immunohistochemical study demonstrated that CD8 T cells were predominant at both interface hepatitis and centrilobular necrosis, while CD79α-positive B lineage cells were predominant at interface hepatitis. These results suggest that acute-onset AIH includes both acute presentation and acute exacerbation of chronic disease and that centrilobular necrosis might be a prevailing pathological feature. |
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