Premium
Clinical characteristics of fulminant‐type autoimmune hepatitis: an analysis of eleven cases
Author(s) -
MIYAKE Y.,
IWASAKI Y.,
TERADA R.,
ONISHI T.,
OKAMOTO R.,
SAKAI N.,
SAKAGUCHI K.,
SHIRATORI Y.
Publication year - 2006
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2006.02894.x
Subject(s) - medicine , autoimmune hepatitis , liver transplantation , fulminant hepatitis , fulminant , gastroenterology , hepatitis , transplantation , fulminant hepatic failure , bilirubin , immunology
Summary Background Although a few adult cases of fulminant‐type autoimmune hepatitis have been reported, their clinical features and prognosis have remained uncertain. Aim To assess the clinical features and prognosis of patients with fulminant‐type autoimmune hepatitis. Methods Eleven patients (10%) diagnosed with fulminant‐type autoimmune hepatitis in accordance with the 1999 criteria of the International Autoimmune Hepatitis Group were analysed. Results All 11 patients were female, with a median age of 53 years. Five patients survived without liver transplantation, one received a liver transplantation, and five died without liver transplantation. Nine patients (82%) survived for 2 weeks or more following diagnosis, without liver transplantation. Except for the patient receiving a liver transplantation, serum total bilirubin levels measured during the clinical course were significantly higher in non‐survivors than in survivors, although the accompanying serum alanine aminotransferase levels measured for the two groups were similar. Most significantly, serum total bilirubin levels in non‐survivors worsened during days 8–15, while levels in survivors improved during the same period. Conclusions The short‐term prognosis for patients with fulminant‐type autoimmune hepatitis may be good. However, patients whose serum total bilirubin levels worsen during days 8–15 should be considered for liver transplantation.