Serologic markers compared with liver biopsy for monitoring disease activity in autoimmune hepatitis.
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Serologic markers compared with liver biopsy for monitoring disease activity in autoimmune hepatitis. / Lüth, Stefan; Herkel, Johannes; Kanzler, Stephan; Frenzel, Christian; Galle, Peter R; Dienes, Hans P; Schramm, Christoph; Lohse, Ansgar W.
In: J CLIN GASTROENTEROL, Vol. 42, No. 8, 8, 2008, p. 926-930.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Serologic markers compared with liver biopsy for monitoring disease activity in autoimmune hepatitis.
AU - Lüth, Stefan
AU - Herkel, Johannes
AU - Kanzler, Stephan
AU - Frenzel, Christian
AU - Galle, Peter R
AU - Dienes, Hans P
AU - Schramm, Christoph
AU - Lohse, Ansgar W.
PY - 2008
Y1 - 2008
N2 - GOALS/BACKGROUND: Disease activity and response to treatment in autoimmune hepatitis is assessed best by liver biopsy, which does not suit for regular disease monitoring. It is frequent clinical practice to follow disease by assessment of serologic markers. Here, we assessed the diagnostic fidelity of this clinical practice. STUDY: One hundred thirty-one biopsies from 82 patients with autoimmune hepatitis were analyzed for histologic activity. Serum samples, taken at the time of biopsy, were analyzed for aminotransferases [alanine aminotransferase (ALT), aspartate aminotransferase], IgG, and gamma-globulin levels and compared with histology. RESULTS: All serum parameters were significantly associated with histologic activity (P/=6) with 99% sensitivity. Elevation of either IgG or ALT was associated with residual inflammatory activity in almost all patients. Histologic remission is reliably indicated by normalization of both serum parameters, but about half of the patients with normal serum parameters still showed residual histologic activity of histologic activity index (HAI) 4 or 5. However, our patients with HAI scores 4 or 5 were at significantly lower risk of fibrosis progression than patients with scores >/=6 (P
AB - GOALS/BACKGROUND: Disease activity and response to treatment in autoimmune hepatitis is assessed best by liver biopsy, which does not suit for regular disease monitoring. It is frequent clinical practice to follow disease by assessment of serologic markers. Here, we assessed the diagnostic fidelity of this clinical practice. STUDY: One hundred thirty-one biopsies from 82 patients with autoimmune hepatitis were analyzed for histologic activity. Serum samples, taken at the time of biopsy, were analyzed for aminotransferases [alanine aminotransferase (ALT), aspartate aminotransferase], IgG, and gamma-globulin levels and compared with histology. RESULTS: All serum parameters were significantly associated with histologic activity (P/=6) with 99% sensitivity. Elevation of either IgG or ALT was associated with residual inflammatory activity in almost all patients. Histologic remission is reliably indicated by normalization of both serum parameters, but about half of the patients with normal serum parameters still showed residual histologic activity of histologic activity index (HAI) 4 or 5. However, our patients with HAI scores 4 or 5 were at significantly lower risk of fibrosis progression than patients with scores >/=6 (P
M3 - SCORING: Zeitschriftenaufsatz
VL - 42
SP - 926
EP - 930
JO - J CLIN GASTROENTEROL
JF - J CLIN GASTROENTEROL
SN - 0192-0790
IS - 8
M1 - 8
ER -
