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BRIEF COMMUNICATION

Reversibility of Hepatic Fibrosis in Autoimmune Hepatitis

Jean-Francois Dufour, MD; Ronald DeLellis, MD; and Marshall M. Kaplan, MD

1 December 1997 | Volume 127 Issue 11 | Pages 981-985

Background: Hepatic fibrosis and cirrhosis occur in many types of chronic liver injury and generally seem to be irreversible.

Objective: To determine whether cirrhosis caused by autoimmune hepatitis can be reversible.

Design: Retrospective study.

Patients: Eight patients with autoimmune hepatitis and cirrhosis who responded to medical therapy and had follow-up liver biopsy while in clinical and biochemical remission.

Measurements: Biopsy specimens were randomly coded in an unpaired manner according to patient and were read independently by two pathologists using the Knodell scoring system.

Results: The median alanine aminotransferase level decreased from 10.30 µkat/L to 0.37 µkat/L, the median serum bilirubin level decreased from 70 µmol/L to 10 µmol/L, and the median serum albumin level increased from 34 g/L to 43 g/L. Cirrhosis, extensive fibrosis, or both were present in all patients at diagnosis but were not present on follow-up liver biopsy. The median Knodell score decreased from 14.0 to 1.3, and the median fibrosis score decreased from 3.3 to 0.8.

Conclusion: Hepatic fibrosis and cirrhosis may be reversible in some patients in whom autoimmune hepatitis responds to treatment.

Author and Article Information

From New England Medical Center and Tufts University Medical School, Boston, Massachusetts.
Grant Support: In part by National Institutes of Health training grant #T32-DK07701 and by the American Gastroenterology Association (Dr. Dufour).
Requests for Reprints: Marshall M. Kaplan, MD, Box 233, Division of Gastroenterology, New England Medical Center, 750 Washington Street, Boston, MA 02111.
Current Author Addresses: Dr. Dufour: Department of Pathology, New England Medical Center, 750 Washington Street, Boston, MA 02111.

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