特殊人群及特殊类型自身免疫性肝炎的临床新进展

李艳清; 董洪静; 刘晓雯; 高沿航

doi:10.3969/j.issn.1001-5256.2018.06.044

特殊人群及特殊类型自身免疫性肝炎的临床新进展

DOI: 10.3969/j.issn.1001-5256.2018.06.044

吉林大学白求恩第一医院肝胆胰内科

基金项目:

国家重点研发计划“精准医学研究”重点专项(SQ2017YFSF090159)；国家艾滋病和病毒性肝炎等重大传染病防治专项(2017ZX10202202)；吉林省科技发展计划项目(20160101097jc)；

详细信息

中图分类号: R575.1
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出版历程
- 收稿日期: 2018-03-02
- 出版日期: 2018-06-20

Latest clinical advances in autoimmune hepatitis in special populations and special types of autoimmune hepatitis

Department of Hepatology, The First Hospital of Jilin University

Research funding:

摘要

摘要: 近年来,自身免疫性肝炎(AIH)发病率有上升趋势,引起了越来越多临床医生的关注。但目前特殊人群及特殊类型AIH的诊疗尚缺少一定的规范性。总结了某些特殊人群(包括儿童、孕妇、男性及老年)以及某些特殊类型(包括无症状、暴发性、经治、重叠综合征、药物诱导、肝移植术后以及自身抗体阴性)的AIH临床诊疗特点及治疗新进展,以期对临床实践中该疾病特殊情况的处理有所帮助。随着AIH发病率的增加,临床医生应该加强对AIH,尤其是特殊人群及特殊类型AIH的认识,以便于临床工作。目前,许多与AIH管理相关的问题仍有待解决。未来需开展关于AIH的大规模前瞻性的临床试验及深入的基础研究。
- 肝炎,自身免疫性 /
- 综述
Abstract: In recent years, the incidence rate of autoimmune hepatitis (AIH) is gradually increasing, which has attracted more and more attention from clinicians. However, there still lacks standardization in the diagnosis and treatment of special types of AIH and AIH in special populations. This article summarizes the latest advances in the clinical diagnosis and treatment of special types of AIH (including asymptomatic AIH, fulminant AIH, treatment-experienced AIH, overlap syndrome, drug-induced AIH, post-liver transplantation AIH, and autoantibody-negative AIH) and AIH in special populations (including children, pregnant women, male patients, and elderly patients) , in order to provide help to the management of the special conditions of this disease in clinical practice. With the increase in the incidence rate of AIH, clinicians should deepen the understanding of AIH in special populations and special types of AIH in order to facilitate clinical work. At present, many serious issues in the management of AIH need to be resolved. Large-scale prospective clinical trials and in-depth basic research on AIH will be conducted in future.
- hepatitis, autoimmune /
- review

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参考文献(46)

[1]COROUGE M, MALLET V, VALLET-PICHARD A, et al.Increasing incidence of autoimmune hepatitis[J].J Hepatol, 2013, 58:s229-s407.

[2]SCHRAMM C, LOHSE AW.Autoimmune hepatitis on the rise[J].J Hepatol, 2014, 60 (3) :478-479.

[3]van GERVEN NM, de BORE YS, MULDER CJ, et al.Autoimmune hepatitis[J].World J Gastroenterol, 2016, 22 (19) :4651-4661.

[4]MANNS MP, LOHSE AW, VERGANI D.Autoimmune hepatitis-Update 2015[J].J Hepatol, 2015, 62 (1 Suppl) :s100-s111.

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

[6]LIBERAL R, VERGANI D, MIELI-VERGANI G.Paediatric autoimmune liver disease[J].Dig Dis, 2015, 33 (Suppl 2) :36-46.

[7]JUNGE N, TIEDAU M, VERBOOM M, et al.Human leucocyte antigens and pediatric autoimmune liver disease:Diagnosis and prognosis[J].Eur J Pediatr, 2016, 175 (4) :527-537.

[8]PNIEWSKA A, SOBOLEWSKA-PILARCZYK M, PAWLOWSKA M.Evaluation of the effectiveness of treatment with prednisone and azathioprine of autoimmune hepatitis in children[J].Prz Gastroenterol, 2016, 11 (1) :18-23.

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

[10]PERINI L, FRANCESCHET, CAZZAGON N, et al.Autoimmune hepatitis:clinical, laboratory and survival analysis in children and adults[J].J Hepatol, 2016, 64 (2) :s633.

[11]ZIZZO AN, VALENTINO PL, SHAH PS, et al.Second-line agents in pediatric patients with autoimmune hepatitis:A systematic review and meta-analysis[J].J Pediatr Gastroenterol Nutr, 2017, 65 (1) :6-15.

[12]KOSTYRKO O, SHUMILOV P, SHIGOLEVA N.Mycophenolate mofetil for the treatment of autoimmune hepatitis in children[J].J Hepatol, 2016, 64:s631-s832.

[13]DIESTELHORST J, JUNGE N, SCHLUE J, et al.Pediatric autoimmune hepatitis shows a disproportionate decline of regulatory T cells in the liver and of IL-2 in the blood of patients undergoing therapy[J].PLo S One, 2017, 12 (7) :e0181107.

[14]DANIELSSON BORSSEN A, WALLERSTEDT S, NYHLIN N, et al.Pregnancy and childbirth in women with autoimmune hepatitis is safe, even in compensated cirrhosis[J].Scand J Gastroenterol, 2016, 51 (4) :479-485.

[15]MENDIZABAL M, MARCIANO S, VIDELA MG, et al.Fulminant presentation of autoimmune hepatitis:Clinical features and early predictors of corticosteroid treatment failure[J].Eur J Gastroenterol Hepatol, 2015, 27 (6) :644-648.

[16]PARKER R, OO YH, ADAMS DH.Management of patients with difficult autoimmune hepatitis[J].Ther Adv Gastroenterol, 2012, 5 (6) :421-437.

[17]WESTBROOK RH, DUSHEIKO G, WILLIAMSON C.Pregnancy and liver disease[J].J Hepatol, 2016, 64 (4) :933-945.

[18]LAMMERT C, LOY VM, OSHIMA K, et al.Management of difficult cases of autoimmune hepatitis[J].Curr Gastroenterol Rep, 2016, 18 (2) :9.

[19]MCFARLANE IG, HENEGHAN MA.Autoimmunity and the female liver[J].Hepatol Res, 2004, 28 (4) :171-176.

[20]MONTANON-LOZA AJ, CARPENTER HA, CZAJA AJ.Predictive factors for hepatocellular carcinoma in type 1 autoimmune hepatitis[J].Am J Gastroenterol, 2008, 103 (8) :1944-1951.

[21]AL-CHALABI T, UNDERHILL JA, PORTMANN BC, et al.Impact of gender on the long-term outcome and survival of patients with autoimmune hepatitis[J].J Hepatol, 2008, 48 (1) :140-147.

[22]DONET JA, PERLINI EF, GILINSKY D, et al.Impact of gender on clinical presentation, response to treatment, and long-term outcomes in an ethnically diverse population of patients with autoimmune hepatitis[J].J Hepatol, 2016, 64:s425-s630.

[23]STRASSBURG CP, MANNS MP.Autoimmune hepatitis in the elderly:What is the difference?[J].J Hepatol, 2006, 45 (4) :480-482.

[24]MURATORI P, LALANNE C, BARBATO E, et al.Features and progression of asymptomatic autoimmune hepatitis in italy, clinical gastroenterology and hepatology[J].Clin Gastroenterol Hepatol, 2016, 14 (1) :139-146.

[25]VISSEREN T, DARWISH MURAD S.Recurrence of primary sclerosing cholangitis, primary biliary cholangitis and auto-immune hepatitis after liver transplantation[J].Best Pract Res Clin Gastroenterol, 2017, 31 (2) :187-198.

[26]PADILLA M, MAYORGA R, CARRASCO F, et al.Liver transplantation for autoimmune hepatitis in Peru:Outcomes and recurrence[J].Ann Hepatol, 2012, 11 (2) :222-227.

[27]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.

[28]FAISAL N, RENNER EL.Recurrence of autoimmune liver diseases after liver transplantation[J].World J Hepatol, 2015, 7 (29) :2896-2905.

[29]SRIVASTAVA S, BOYER JL.Psychological stress is associated with relapse in type 1 autoimmune hepatitis[J].Liver Int, 2010, 30 (10) :1439-1447.

[30]BAIRY I, BERWAL A, SESHADRI S.Autoimmune hepatitisprimary biliary cirrhosis overlap syndrome[J].J Clin Diagn Res, 2017, 11 (7) :od07-od09.

[31]NGUY EN HH, SHAHEEN AA.Development of a multivariate model using serum biomarkers to better define primary biliary cholangitis (PBC) -autoimmune hepatitis (AIH) overlap syndrome[J].J Hepatol, 2017, 66:s333-s542.

[32]PARK Y, CHO Y, CHO EJ, et al.Retrospective analysis of autoimmune hepatitis-primary biliary cirrhosis overlap syndrome in Korea:Characteristics, treatments, and outcomes[J].Clin Mol Hepatol, 2015, 21 (2) :150-157.

[33]WARLING O, BOVY C, COIMBRA C.Overlap syndrome consisting of PSC-AIH with concomitant presence of a membranous glomerulonephritis and ulcerative colitis[J].World J Gastroenterol, 2014, 20 (16) :4811-4816.

[34]ZHANG HW, LI SN.A meta-analysis of ursodeoxycholic acid therapy versus combination therapy with corticosteroids for PBCAIH-overlap synrome:Evidence from 97 monotherapy and 117combinations[J].Prz Gastroenterol, 2015, 10 (3) :148-155.

[35]ZENOUZI R, LOHSE AW.Long-term outcome in PSC/AIH‘overlap syndrome’:Does immunosuppression also treat the PSC component?[J].J Hepatol, 2014, 61 (5) :1189-1191.

[36]de BOER YS, KOSINSKI AS, URBAN TJ, et al.Features of autoimmune hepatitis in patients with drug-induced liver injury[J].Clin Gastroenterol Hepatol, 2017, 15 (1) :103-112.

[37]AIZAWA Y, HOKARI A.Autoimmune hepatitis:Current challenges and future prospects[J].Clin Exp Gastroenterol, 2017, 10:9-18.

[38]LICATA A, MAIDA M, CABIBI D, et al.Clinical features and outcomes of patients with drug-induced autoimmune hepatitis:A retrospective cohort study[J].Dig Liver Dis, 2014, 46 (12) :1116-1120.

[39]TAKEDA K, ODA M, OKADA T, et al.Over-the-counter drug induced autoimmune hepatitis[J].Intern Med, 2016, 55 (10) :1293-1297.

[40]OH HJ, MOK YM, BAEK MS.Co-development of autoimmune hepatitis and Sj9gren's syndrome triggered by the administration of herbal medicines[J].Clin Mol Hepatol, 2013, 19 (3) :305-308.

[41]THULUVATH PJ, WAGENNAR RR, VERMA S.Gender and ethnic differences in the post-liver transplant outcomes of patients with autoimmune hepatitis with acute liver failure at initial presentation:A case-control study[J].Arch Med Sci, 2015, 11 (6) :1227-1235.

[42]KRSHNAMOORTHY TL, MIEZYNSKA-KURTYCZ J, HODSON J, et al.Long term low dose steroid triple immunosuppressive regimens in post transplant autoimmune hepetitis (AIH) patients reduces the incidence of recurrent disease and is not associated with increased mortality[J].J Hepatol, 2015, 62:s263-s864.

[43]XU YT, LIU DJ, MENG FY, LI GB, et al.Possible benefit of splenectomy in liver transplantation for autoimmune hepatitis[J].Hepatobiliary Pancreat Dis Int, 2014, 13 (3) :328-331.

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

[45]CZAJA AJ.Autoantibody-negative autoimmune hepatitis[J].Dig Dis Sci, 2012, 57 (3) :610-624.

[46]WANG XQ, 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.

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