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Advanced histology and impaired liver regeneration are associated with disease severity in acute‐onset autoimmune hepatitis
Author(s) -
Fujiwara Keiichi,
Nakano Masayuki,
Yasui Shin,
Okitsu Koichiro,
Yonemitsu Yutaka,
Yokosuka Osamu
Publication year - 2011
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2011.03790.x
Subject(s) - autoimmune hepatitis , fulminant , fulminant hepatitis , pathology , fulminant hepatic failure , pathological , immunohistochemistry , medicine , necrosis , regeneration (biology) , cytokeratin , progenitor cell , liver disease , hepatitis , gastroenterology , biology , disease , liver transplantation , stem cell , transplantation , genetics , microbiology and biotechnology
Fujiwara K, Nakano M, Yasui S, Okitsu K, Yonemitsu Y & Yokosuka O
(2011) Histopathology 58 , 693–704
Advanced histology and impaired liver regeneration are associated with disease severity in acute‐onset autoimmune hepatitis Aims: Some cases of acute‐onset autoimmune hepatitis (AIH) develop into severe or fulminant forms showing massive/submassive hepatic necrosis, and have a poor prognosis. The pathological features of acute‐onset AIH remain uncertain. Ductular (intermediate) hepatocytes after massive/submassive necrosis may serve as hepatic progenitor cells, and could be seen as cytokeratin 7 (CK7)‐positive hepatocytes in immunohistochemistry. Therefore, the aim was to examine histological features to obtain a better evaluation of acute‐onset AIH. Methods: The histological features of 27 clinically acute‐onset AIH patients were examined by immunohistochemistry using CK7. Results: On staining for CK7, intermediate hepatocytes were less commonly present ( P < 0.001) and ductular reactions were more commonly present ( P < 0.001) in severe/fulminant patients than in non‐severe ones. In severe and fulminant patients, intermediate hepatocytes and intralobular progenitor cells were more commonly present ( P < 0.005 and P < 0.05, respectively) and ductular reactions were less commonly present ( P = 0.007) in recovered patients than in dead ones. Severe patients had more clinically and histologically advanced disease. Conclusions: Immunohistochemical evalution using CK7 might be a useful tool for evaluating liver regeneration, and intermediate hepatocytes and progenitor cells might play an important role in liver regeneration after massive and submassive necrosis in acute‐onset AIH.