HEPATOLOGY: Applicability of the IAIHG scoring system to the diagnosis of antimitochondrial-anti-M2 seropositive variant form of autoimmune hepatitis
Background and Aims:According to the International Autoimmune Hepatitis Group (IAIHG) criteria, circulating antimitochondrial antibodies (AMA) do not support the diagnosis of autoimmune hepatitis (AIH). The aims of this study were to characterize a subset of patients with AIH who have AMA and antiM2...
Saved in:
Published in | Journal of gastroenterology and hepatology Vol. 21; no. 5; pp. 887 - 893 |
---|---|
Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
01.05.2006
|
Online Access | Get full text |
Cover
Loading…
Abstract | Background and Aims:According to the International Autoimmune Hepatitis Group (IAIHG) criteria, circulating antimitochondrial antibodies (AMA) do not support the diagnosis of autoimmune hepatitis (AIH). The aims of this study were to characterize a subset of patients with AIH who have AMA and antiM2 seropositivity, and to assess the applicability of the revised scoring system of the IAIHG in the diagnosis of this variant form of AIH. Methods:Eighteen patients with AMA-AIH were enrolled and compared with 206 classical AIH and 85 primary biliary cirrhosis (PBC) controls. Human leukocyte antigen (HLA) class II alleles were determined by polymerase chain reaction (PCR) amplification with sequence-specific primers, and biopsies were blindly reevaluated. Results:The patients with AMA-AIH were, on average, older than patients with classical AIH and had an hepatocellular pattern of elevated liver enzymes, hypergammaglobulinemia and lower levels of cholesterol, when compared with PBC controls. There were no histological signs of PBC or overlapping forms in any AMA-AIH biopsies. The majority of patients with AMA-AIH carried HLA antigens associated with classical AIH (DRB1*03, n = 5; DRB1*04, n = 7, and DRB1*13, n = 6). Pretreatment scores classified all AMA-AIH patients with probable (n = 17) or improbable (n = 1) AIH. After treatment, only 28% of AMA-AIH patients reached scores for definite diagnosis, compared with 90.1% of AIH-1 and 96.4 AIH-2. In the AMA-AIH group, only patients who relapsed after immunosuppressive drug withdrawal could be classified with definite AIH. Conclusions:AMA-AIH shares common features with classical AIH. The diagnosis of AMA-AIH may be swayed by the IAIHG criteria, rendering questionable the applicability of the revised scoring system to this variant form of AIH. |
---|---|
AbstractList | Background and Aims:According to the International Autoimmune Hepatitis Group (IAIHG) criteria, circulating antimitochondrial antibodies (AMA) do not support the diagnosis of autoimmune hepatitis (AIH). The aims of this study were to characterize a subset of patients with AIH who have AMA and antiM2 seropositivity, and to assess the applicability of the revised scoring system of the IAIHG in the diagnosis of this variant form of AIH. Methods:Eighteen patients with AMA-AIH were enrolled and compared with 206 classical AIH and 85 primary biliary cirrhosis (PBC) controls. Human leukocyte antigen (HLA) class II alleles were determined by polymerase chain reaction (PCR) amplification with sequence-specific primers, and biopsies were blindly reevaluated. Results:The patients with AMA-AIH were, on average, older than patients with classical AIH and had an hepatocellular pattern of elevated liver enzymes, hypergammaglobulinemia and lower levels of cholesterol, when compared with PBC controls. There were no histological signs of PBC or overlapping forms in any AMA-AIH biopsies. The majority of patients with AMA-AIH carried HLA antigens associated with classical AIH (DRB1*03, n = 5; DRB1*04, n = 7, and DRB1*13, n = 6). Pretreatment scores classified all AMA-AIH patients with probable (n = 17) or improbable (n = 1) AIH. After treatment, only 28% of AMA-AIH patients reached scores for definite diagnosis, compared with 90.1% of AIH-1 and 96.4 AIH-2. In the AMA-AIH group, only patients who relapsed after immunosuppressive drug withdrawal could be classified with definite AIH. Conclusions:AMA-AIH shares common features with classical AIH. The diagnosis of AMA-AIH may be swayed by the IAIHG criteria, rendering questionable the applicability of the revised scoring system to this variant form of AIH. |
Author | Goncalves, Luciana Lofego Bittencourt, Paulo Lisboa De Melo, Evandro Sobroza Abrantes-Lemos, Clarice Pires Farias, Alberto Queiroz Nakhle, Maria Cristina Carrilho, Flair Jose Cancado, Eduardo Luiz Rachid Porta, Gilda |
Author_xml | – sequence: 1 givenname: Alberto surname: Farias middlename: Queiroz fullname: Farias, Alberto Queiroz – sequence: 2 givenname: Luciana surname: Goncalves middlename: Lofego fullname: Goncalves, Luciana Lofego – sequence: 3 givenname: Paulo surname: Bittencourt middlename: Lisboa fullname: Bittencourt, Paulo Lisboa – sequence: 4 givenname: Evandro surname: De Melo middlename: Sobroza fullname: De Melo, Evandro Sobroza – sequence: 5 givenname: Clarice surname: Abrantes-Lemos middlename: Pires fullname: Abrantes-Lemos, Clarice Pires – sequence: 6 givenname: Gilda surname: Porta fullname: Porta, Gilda – sequence: 7 givenname: Maria surname: Nakhle middlename: Cristina fullname: Nakhle, Maria Cristina – sequence: 8 givenname: Flair surname: Carrilho middlename: Jose fullname: Carrilho, Flair Jose – sequence: 9 fullname: Cancado, Eduardo Luiz Rachid |
BookMark | eNqNi7FOwzAURS1UJFrgH97ElmAnbkPYIlSaSqAydGGqTOo0rmy_kOdU9EP4X9IKMXOXK91z7oSNPHrNGAgeiyH3-1hIySORyVmccD6LuRQpj78u2PgPjNiYP4hplKciv2IToj3nXPJsOmbf5fytWK9eVov3Ryja1ppKfRhrwhGwhtBoWBbLcgFUYWf8DuhIQTsIeGZbo3YeydBJVj4YZwJWDfptZ5SNTkv0mgDpDttBC-ag4aAG5gPU2LnzrQ9onOu9hka3KgwW3bDLWlnSt799ze6e5-unMmo7_Ow1hY0zVGlrldfY00bkUqZJnqX_Fn8AzNRlOw |
ContentType | Journal Article |
DBID | 7T5 7U9 H94 |
DOI | 10.1111/j.1440-1746.2006.04130.x |
DatabaseName | Immunology Abstracts Virology and AIDS Abstracts AIDS and Cancer Research Abstracts |
DatabaseTitle | Virology and AIDS Abstracts AIDS and Cancer Research Abstracts Immunology Abstracts |
DatabaseTitleList | Virology and AIDS Abstracts |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 1440-1746 |
EndPage | 893 |
GroupedDBID | --- .3N .GA .Y3 05W 0R~ 10A 1OB 1OC 29K 31~ 33P 36B 3SF 4.4 50Y 50Z 51W 51X 52M 52N 52O 52P 52R 52S 52T 52U 52V 52W 52X 53G 5GY 5HH 5LA 5VS 66C 702 7PT 7T5 7U9 8-0 8-1 8-3 8-4 8-5 8UM 930 A01 A03 AAESR AAEVG AAHHS AANLZ AAONW AASGY AAXRX AAZKR ABCQN ABCUV ABJNI ABPVW ABQWH ABXGK ACAHQ ACBWZ ACCFJ ACCZN ACGFS ACGOF ACMXC ACPOU ACPRK ACXBN ACXQS ADBBV ADBTR ADEOM ADIZJ ADKYN ADMGS ADOZA ADXAS ADZMN AEEZP AEGXH AEIGN AEIMD AENEX AEQDE AEUQT AEUYR AFBPY AFEBI AFFPM AFGKR AFPWT AFZJQ AHBTC AIACR AITYG AIURR AIWBW AJBDE ALAGY ALMA_UNASSIGNED_HOLDINGS ALUQN AMBMR AMYDB ASPBG ATUGU AVWKF AZBYB AZFZN AZVAB BAFTC BDRZF BFHJK BHBCM BMXJE BROTX BRXPI BY8 C45 CAG COF CS3 D-6 D-7 D-E D-F D-I DCZOG DPXWK DR2 DRFUL DRMAN DRSTM DU5 EBS EJD EMOBN ESX EX3 F00 F01 F04 F5P FEDTE FUBAC G-S G.N GODZA H.X H94 HGLYW HVGLF HZI HZ~ IHE IX1 J0M K48 KBYEO KMS LATKE LC2 LC3 LEEKS LH4 LITHE LOXES LP6 LP7 LUTES LW6 LYRES MEWTI MK4 MRFUL MRMAN MRSTM MSFUL MSMAN MSSTM MXFUL MXMAN MXSTM N04 N05 N9A NF~ O66 O9- OIG OVD P2P P2W P2X P2Z P4B P4D Q.N Q11 QB0 R.K ROL RX1 SUPJJ TEORI UB1 W8V W99 WBKPD WH7 WHWMO WIH WIJ WIK WOHZO WOQ WOW WQJ WRC WUP WVDHM WXI WXSBR XG1 YFH ZZTAW ~IA ~WT |
ID | FETCH-proquest_miscellaneous_194432973 |
ISSN | 0815-9319 |
IngestDate | Thu Aug 15 23:43:25 EDT 2024 |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 5 |
Language | English |
LinkModel | OpenURL |
MergedId | FETCHMERGED-proquest_miscellaneous_194432973 |
Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 content type line 23 ObjectType-Feature-2 |
PQID | 19443297 |
PQPubID | 23462 |
ParticipantIDs | proquest_miscellaneous_19443297 |
PublicationCentury | 2000 |
PublicationDate | 20060501 |
PublicationDateYYYYMMDD | 2006-05-01 |
PublicationDate_xml | – month: 05 year: 2006 text: 20060501 day: 01 |
PublicationDecade | 2000 |
PublicationTitle | Journal of gastroenterology and hepatology |
PublicationYear | 2006 |
SSID | ssj0004075 |
Score | 3.6316576 |
Snippet | Background and Aims:According to the International Autoimmune Hepatitis Group (IAIHG) criteria, circulating antimitochondrial antibodies (AMA) do not support... |
SourceID | proquest |
SourceType | Aggregation Database |
StartPage | 887 |
Title | HEPATOLOGY: Applicability of the IAIHG scoring system to the diagnosis of antimitochondrial-anti-M2 seropositive variant form of autoimmune hepatitis |
URI | https://search.proquest.com/docview/19443297 |
Volume | 21 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3JbtswECXcFCh6KdINTZO0PBS9CCosW4uVm5HYdQo5WxXAN4OyqMAXEZApA8l_5BvzG5khqcVt0rS9CAIlkqLmYTiceRwS8iVYpIHP3IGdMB8XKGFqh5mX2YnvspB3k8BRpzVMT_zJpftj5s06nbsWa6mUybfFzYP7Sv5HqlAGcsVdsv8g2bpRKIB7kC9cQcJw_SsZT0Znw1hFgpR_T8eiFdv1uor9Hw-PJ9-t1ULz7HTe5sreTDXNTmckgT-Me50EqMM8xW-3scSe9iwYitDcrjW31rC2ZpjPCWxdVa2UYol7TDjYnMjOlsvVIwbvFVvJQmAO0KJJ_KQqbbj2x9iDPiMZ82_Bt56XfFmIm5oqJHIA1lrrt6hEtwyzIpHxK9G4_CWuBaBvWdEfhRXBelbUs9AR6DOu4064mkgLYf0UCXTDfnWEVLTDSl86nh32jQbmWp-r0HVgvJxG4fecFrC9lvYemLnfGAL66MY_zDGmbRPSQnOg4p6203qfnM7Hl1E0j0ez-Bl53gtCD70ERxdNnjNXZ4SuR7BJOXuwn99sB2UQxdvklREsHWpYviYdnr8hL6aGq_GW3DboPKAb2KQio4A_qrBJDTapxiaVQj2rsYkvP4pN2sYmNdikiE1VrcYmrbH5jnwdj-LDiV0Naw6KDqNXLOeiXM2d0HX7eNLae7KVi5x_gH-UJmkGRiZYwdz1WZA4fZelg0WPdfEUgu4O-fxEYx-ffGOXvGzAtke2ZFHyfbBDZfJJyfAesBSVzA |
link.rule.ids | 315,786,790,27957,27958 |
linkProvider | Wiley-Blackwell |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=HEPATOLOGY%3A+Applicability+of+the+IAIHG+scoring+system+to+the+diagnosis+of+antimitochondrial-anti-M2+seropositive+variant+form+of+autoimmune+hepatitis&rft.jtitle=Journal+of+gastroenterology+and+hepatology&rft.au=Farias%2C+Alberto+Queiroz&rft.au=Goncalves%2C+Luciana+Lofego&rft.au=Bittencourt%2C+Paulo+Lisboa&rft.au=De+Melo%2C+Evandro+Sobroza&rft.date=2006-05-01&rft.issn=0815-9319&rft.eissn=1440-1746&rft.volume=21&rft.issue=5&rft.spage=887&rft.epage=893&rft_id=info:doi/10.1111%2Fj.1440-1746.2006.04130.x&rft.externalDBID=NO_FULL_TEXT |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0815-9319&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0815-9319&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0815-9319&client=summon |