Repository logo
 
Publication

Presence of Multilobular Necrosis on Liver Biopsy Identifies Corticosteroid Responsiveness in Acute Indeterminate Hepatitis

2022-04Journal article Open access
Simple item page
dc.contributor.authorLin, S
dc.contributor.authorAraújo, C
dc.contributor.authorHall, A
dc.contributor.authorKumar, R
dc.contributor.authorPhillips, A
dc.contributor.authorHassan, M
dc.contributor.authorEngelmann, C
dc.contributor.authorQuaglia, A
dc.contributor.authorJalan, R
dc.date.accessioned2023-11-28T15:05:19Z
dc.date.available2023-11-28T15:05:19Z
dc.date.issued2022-04
dc.description.abstractBackground and aims: Treatment of patients with severe indeterminate hepatitis (IAH) is an unmet need. Corticosteroids are often used in the management of these patients but criteria for the selection of patients for this intervention are arbitrary. The aims of this study were to analyse the clinical and pathological features of patients with IAH to define predictors of corticosteroid responsiveness. Methods: This study included consecutive patients with acute indeterminate hepatitis admitted to a single hospital and underwent a liver biopsy. The clinical manifestation and histopathological features of steroid and non-steroid groups were compared and their relationship with corticosteroids response was evaluated. Results: Forty-eight patients were included, 24 (50%) recovered and the other half underwent liver transplantation or died within 3-months. Of the 48 cases, 24 received corticosteroids (initial dose of 45 ± 12 mg prednisolone). Corticosteroids were initiated 2.7 ± 3.8 days after admission. Liver biopsy was performed 2-days (median, IQR 1-3) after admission. Fifteen (62.5%) patients receiving corticosteroids survived without transplantation compared with 9 (37.5%) that did not receive steroids (P = .149). In those with multilobular necrosis, 50% reduction in the death/transplantation rate was observed after steroid treatment (P = .018). In patients without multilobular necrosis and with or without perivenulitis, corticosteroids did not impact the outcome. Response to corticosteroids was independent of the MELD score. Conclusions: The presence of multilobular necrosis on liver biopsy helps identify a subgroup of IAH cases who may benefit from the administration of corticosteroids.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationLiver Int . 2022 Apr;42(4):853-863. doi: 10.1111/liv.15144.pt_PT
dc.identifier.doi10.1111/liv.15144pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4746
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectCHLC ANPATpt_PT
dc.subjectHumanspt_PT
dc.subjectAdrenal Cortex Hormones* / therapeutic usept_PT
dc.subjectNecrosispt_PT
dc.subjectBiopsypt_PT
dc.subjectHepatitis* / drug therapypt_PT
dc.subjectTreatment Outcomept_PT
dc.titlePresence of Multilobular Necrosis on Liver Biopsy Identifies Corticosteroid Responsiveness in Acute Indeterminate Hepatitispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage863pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage853pt_PT
oaire.citation.titleLiver Internationalpt_PT
oaire.citation.volume42pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Liver Int 2022 853.pdf
Size:
655.11 KB
Format:
Adobe Portable Document Format
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

ANPAT - Artigos