自身免疫性肝炎诊断和治疗共识(2015)

中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会感染病学分会

doi:10.3969/j.issn.1001-5256.2016.01.002

自身免疫性肝炎诊断和治疗共识(2015)

DOI: 10.3969/j.issn.1001-5256.2016.01.002

中华医学会肝病学分会, 中华医学会消化病学分会, 中华医学会感染病学分会

详细信息

中图分类号: R575.1
计量
- 文章访问数: 5805
- HTML全文浏览量: 445
- PDF下载量: 3629
- 被引次数: 0
出版历程
- 出版日期: 2016-01-20

Consensus on the diagnosis and management of autoimmune hepatitis(2015)

Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Gastroenterology, Chinese Medical Association; Chinese Society of Infectious Diseases, Chinese Medical Association

摘要

摘要:
<正>1概述自身免疫性肝炎（AIH）是一种由针对肝细胞的自身免疫反应所介导的肝脏实质炎症,以血清自身抗体阳性、高免疫球蛋白G（Ig G）和（或）γ-球蛋白血症、肝组织学上存在界面性肝炎为特点,如不治疗常可导致肝硬化、肝衰竭[1]。AIH的临床表现多样,一般表现为慢性、隐匿起病,但也可表现为急性发作,甚至引起急性肝衰竭。20世纪60至80年代,多项临床研究证实,免疫抑制剂治疗可显著改善AIH患者的生物化学指
- 肝炎,自身免疫性 /
- 诊断 /
- 治疗 /
- 共识
- hepatitis,autoimmune /
- diagnosis /
- treatment /
- consensus

HTML全文

参考文献(64)

[1]KRAWITT EL.Autoimmune hepatitis[J].N Engl J Med,2006,354(1):54-66.

[2]YANG F,WANG Q,BIAN Z,et al.Autoimmune hepatitis:east meets west[J].J Gastroenterol Hepatol,2015,30(8):1230-1236.

[3]LIBERAL R,GRANT CR,MIELI-VERGANI G,et al.Autoimmune hepatitis:a comprehensive review[J].J Autoimmun,2013,41:126-139.

[4]GRNBK L,VILSTRUP H,JEPSEN P.Autoimmune hepatitis in Denmark:incidence,prevalence,prognosis,and causes of death.A nationwide registry-based cohort study[J].J Hepatol,2014,60(3):612-617.

[5]CZAJA AJ,MANNS MP.Advances in the diagnosis,pathogenesis,and management of autoimmune hepatitis[J].Gastroenterology,2010,139(1):58-72.

[6]LOHSE AW,MIELI-VERGANI G.Autoimmune hepatitis[J].J Hepatol,2011,55(1):171-182.

[7]OKAZAKI K,UCHIDA K,KOYABU M,et al.IgG 4 cholangiopathy:current concept,diagnosis,and pathogenesis[J].J Hepatol,2014,61(3):690-695.

[8]VERGANI D,ALVAREZ F,BIANCHI FB,et al.Liver autoimmune serology:a consensus statement from the committee for autoimmune serology of the International Autoimmune Hepatitis Group[J].J Hepatol,2004,41(4):677-683.

[9]COUTO CA,BITTENCOURT PL,PORTA G,et al.Antismooth muscle and antiactin antibodies are indirect markers of histological and biochemical activity of autoimmune hepatitis[J].Hepatology,2014,59(2):592-600.

[10]CZAJA AJ,SHUMS Z,NORMAN GL.Frequency and significance of antibodies to soluble liver antigen/liver pancreas in variant autoimmune hepatitis[J].Autoimmunity,2002,35(8):475-483.

[11]ZHAO Y,ZHANG Y,LIU YM,et al.Identification of T cell epitopes on soluble liver antigen in Chinese patients with auto-immune hepatitis[J].Liver Int,2011,31(5):721-729.

[12]HENEGHAN MA,YEOMAN AD,VERMA S,et al.Autoimmune hepatitis[J].Lancet,2013,382(9902):1433-1444.

[13]MIAO Q,BIAN Z,TANG R,et al.Emperipolesis mediated by CD8T cells is a characteristic histopathologic feature of autoimmune hepatitis[J].Clin Rev Allergy Immunol,2015,48(2-3):226-235.

[14]ALVAREZ F,BERG PA,BIANCHI FB,et al.International Autoimmune Hepatitis Group Report:review of criteria for diagnosis of autoimmune hepatitis[J].J Hepatol,1999,31(5):929-938.

[15]HENNES EM,ZENIYA M,CZAJA AJ,et al.Simplified criteria for the diagnosis of autoimmune hepatitis[J].Hepatology,2008,48(1):169-176.

[16]QIU D,WANG Q,WANG H,et al.Validation of the simplified criteria for diagnosis of autoimmune hepatitis in Chinese patients[J].J Hepatol,2011,54(2):340-347.

[17]MANNS MP,CZAJA AJ,GORHAM JD,et al.Diagnosis and management of autoimmune hepatitis[J].Hepatology,2010,51(6):2193-2213.

[18]DHALIWAL HK,HOEROLDT BS,DUBE AK,et al.Long-term prognostic significance of persisting histological activity despite biochemical remission in autoimmune hepatitis[J].Am J Gastroenterol,2015,110(7):993-999.

[19]European Association for the Study of the Liver.EASL clinical practice guidelines:autoimmune hepatitis[J].J Hepatol,2015,63(4):971-1004.

[20]CZAJA AJ.Review article:the prevention and reversal of hepatic fibrosis in autoimmune hepatitis[J].Aliment Pharmacol Ther,2014,39(4):385-406.

[21]MANNS MP,WOYNAROWSKI M,KREISEL W,et al.Budesonide induces remission more effectively than prednisone in a controlled trial of patients with autoimmune hepatitis[J].Gastroenterology,2010,139(4):1198-1206.

[22]ZACHOU K,GATSELIS N,PAPADAMOU G,et al.Mycophenolate for the treatment of autoimmune hepatitis:prospective assessment of its efficacy and safety for induction and maintenance of remission in a large cohort of treatment-nave patients[J].J Hepatol,2011,55(3):636-646.

[23]GLEESON D,HENEGHAN MA,British Society of Gastroenterology.British Society of Gastroenterology(BSG)guidelines for management of autoimmune hepatitis[J].Gut,2011,60(12):1611-1629.

[24]van GERVEN NM,VERWER BJ,WITTE BI,et al.Relapse is almost universal after withdrawal of immunosuppressive medication in patients with autoimmune hepatitis in remission[J].J Hepatol,2013,58(1):141-147.

[25]HARTL J,EHLKEN H,WEILER-NORMANN C,et al.Patient selection based on treatment duration and liver biochemistry increases success rates after treatment withdrawal in autoimmune hepatitis[J].J Hepatol,2015,62(3):642-646.

[26]LEBER WALDENSTRM J.Blutproteine und Nahrungseiweiss[J].Deutsch Z Verdau Stoffwechselkr,1950,15:113-119.

[27]CAMPSEN J,ZIMMERMAN MA,TROTTER JF,et al.Liver transplantation for autoimmune hepatitis and the success of aggressive corticosteroid withdrawal[J].Liver Transpl,2008,14(9):1281-1286.

[28]No authors listed.Effect of prednisone on the survival of patients with cirrhosis of the liver.A report from the Copenhagen Study Group for Liver Diseases[J].Lancet,1969,1(7586):119-121.

[29]COOK GC,MULLIGAN R,SHERLOCK S.Controlled prospective trial of corticosteroid therapy in active chronic hepatitis[J].Q J Med,1971,40(158):159-185.

[30]CARBONE M,NEUBERGER JM.Autoimmune liver disease,autoimmunity and liver transplantation[J].J Hepatol,2014,60(1):210-223.

[31]GUIDO M,BURRA P.De novo autoimmune hepatitis after liver transplantation[J].Semin Liver Dis,2011,31(1):71-81.

[32]KERKAR N,YANNI G.‘De novo’and‘recurrent’autoimmune hepatitis after liver transplantation:a comprehensive review[J].J Autoimmun,2015.[Epub ahead of print]

[33]ZHAO XY,RAKHDA MI,WANG TI,et al.Immunoglobulin G4-associated de novo autoimmune hepatitis after liver transplantation for chronic hepatitis B-and C-related cirrhosis and hepatocellular carcinoma:a case report with literature review[J].Transplant Proc,2013,45(2):824-827.

[34]WANG Q,YANG F,MIAO Q,et al.The clinical phenotypes of autoimmune hepatitis:a comprehensive review[J].J Autoimmun,2015.[Epub ahead of print]

[35]CZAJA AJ.Special clinical challenges in autoimmune hepatitis:the elderly,males,pregnancy,mild disease,fulminant onset,and nonwhite patients[J].Semin Liver Dis,2009,29(3):315-330.

[36]YEOMAN AD,WESTBROOK RH,ZEN Y,et al.Prognosis of acute severe autoimmune hepatitis(AS-AIH):the role of corticosteroids in modifying outcome[J].J Hepatol,2014,61(4):876-882.

[37]YEOMAN AD,WESTBROOK RH,AL-CHALABI T,et al.Diagnostic value and utility of the simplified International Autoimmune Hepatitis Group(IAIHG)criteria in acute and chronic liver disease[J].Hepatology,2009,50(2):538-545.

[38]STRAVITZ RT,LEFKOWITCH JH,FONTANA RJ,et al.Autoimmune acute liver failure:proposed clinical and histological criteria[J].Hepatology,2011,53(2):517-526.

[39]ABE M,HIASA Y,MASUMOTO T,et al.Clinical characteristics of autoimmune hepatitis with histological features of acute hepatitis[J].Hepatol Res,2001,21(3):213-219.

[40]MONTANO-LOZA AJ,CARPENTER HA,CZAJA AJ.Features associated with treatment failure in type 1 autoimmune hepatitis and predictive value of the model of end-stage liver disease[J].Hepatology,2007,46(4):1138-1145.

[41]DYSON JK,WEBB G,HIRSCHFIELD GM,et al.Unmet clinical need in autoimmune liver diseases[J].J Hepatol,2015,62(1):208-218.

[42]WANG QX,JIANG WJ,MIAO Q,et al.Clinical and histological features of autoantibody-negative autoimmune hepatitis in Chinese patients:a single center experience[J].J Dig Dis,2013,14(4):175-180.

[43]BOBERG KM,CHAPMAN RW,HIRSCHFIELD GM,et al.Overlap syndromes:the International Autoimmune Hepatitis Group(IAIHG)position statement on a controversial issue[J].J Hepatol,2011,54(2):374-385.

[44]BEUERS U,GERSHWIN ME,GISH RG,et al.Changing nomenclature for PBC:from'cirrhosis'to'cholangitis'[J].Clin Gastroenterol Hepatol,2015,13(11):1867-1869.

[45]CHAZOUILLRES O,WENDUM D,SERFATY L,et al.Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome:clinical features and response to therapy[J].Hepatology,1998,28(2):296-301.

[46]KUIPER EM,ZONDERVAN PE,van BUUREN HR.Paris criteria are effective in diagnosis of primary biliary cirrhosis and autoimmune hepatitis overlap syndrome[J].Clin Gastroenterol Hepatol,2010,8(6):530-534.

[47]WANG Q,SELMI C,ZHOU X,et al.Epigenetic considerations and the clinical reevaluation of the overlap syndrome between primary biliary cirrhosis and autoimmune hepatitis[J].J Autoimmun,2013,41:140-145.

[48]OZASLAN E,EFE C,HEURGU-BERLOT A,et al.Factors associated with response to therapy and outcome of patients with primary biliary cirrhosis with features of autoimmune hepatitis[J].Clin Gastroenterol Hepatol,2014,12(5):863-869.

[49]FAN Y,WANG Q,WANG Z,et al.The natural history and prognosis of primary biliary cirrhosis with clinical features of autoimmune hepatitis[J].Clin Rev Allerg Immunol,2015.[Epub ahead of print]

[50]GREGORIO GV,PORTMANN B,KARANI J,et al.Autoimmune hepatitis/sclerosing cholangitis overlap syndrome in childhood:a 16-year prospective study[J].Hepatology,2001,33(3):544-553.

[51]SUI M,WU R,HU X,et al.Low prevalence of hepatitis B virus infection in patients with autoimmune diseases in a Chinese patient population[J].J Viral Hepat,2014,21(12):925-929.

[52]CHEN J,ESLICK GD,WELTMAN M.Systematic review with metaanalysis:clinical manifestations and management of autoimmune hepatitis in the elderly[J].Aliment Pharmacol Ther,2014,39(2):117-124.

[53]WESTBROOK RH,YEOMAN AD,KRIESE S,et al.Outcomes of pregnancy in women with autoimmune hepatitis[J].J Autoimmun,2012,38(2-3):j239-j244.

[54]CZAJA AJ,CARPENTER HA.Distinctive clinical phenotype and treatment outcome of type 1 autoimmune hepatitis in the elderly[J].Hepatology,2006,43(3):532-538.

[55]SOLOWAY RD,SUMMERSKILL WH,BAGGENSTOSS AH,et al.Clinical,biochemical,and histological remission of severe chronic active liver disease:a controlled study of treatments and early prognosis[J].Gastroenterology,1972,63(5):820-833.

[56]CZAJA AJ.Autoimmune hepatitis in special patient populations[J].Best Pract Res Clin Gastroenterol,2011,25(6):689-700.

[57]MIELI-VERGANI G,VERGANI D.Autoimmune hepatitis in children:what is different from adult AIH?[J].Semin Liver Dis,2009,29(3):297-306.

[58]FLOREANI A,LIBERAL R,VERGANI D,et al.Autoimmune hepatitis:contrasts and comparisons in children and adults-a comprehensive review[J].J Autoimmun,2013,46:7-16.

[59]WANG Q,QIU D,MA X.Early normalisation of aminotransferase predicts complete biochemical remission in autoimmune hepatitis patients[J].Aliment Pharmacol Ther,2011,34(1):107-109.

[60]YOSHIZAWA K,MATSUMOTO A,ICHIJO T,et al.Long-term outcome of Japanese patients with type 1 autoimmune hepatitis[J].Hepatology,2012,56(2):668-676.

[61]NGU JH,GEARRY RB,FRAMPTON CM,et al.Predictors of poor outcome in patients with autoimmune hepatitis:a population-based study[J].Hepatology,2013,57(6):2399-2406.

[62]HOEROLDT B,MCFARLANE E,DUBE A,et al.Long-term outcomes of patients with autoimmune hepatitis managed at a nontransplant center[J].Gastroenterology,2011,140(7):1980-1989.

[63]GRANT CR,LIBERAL R,HOLDER BS,et al.Dysfunctional CD39(POS)regulatory T cells and aberrant control of T-helper type 17 cells in autoimmune hepatitis[J].Hepatology,2014,59(3):1007-1015.

[64]ZHANG H,LIU Y,BIAN Z,et al.The critical role of myeloidderived suppressor cells and FXR activation in immune-mediated liver injury[J].J Autoimmun,2014,53:55-66.

施引文献

资源附件(0)

访问统计