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Reversibility of Hepatic Fibrosis in Autoimmune Hepatitis
- Jean-Francois Dufour, MD;
- Ronald DeLellis, MD; and
- Marshall M. Kaplan, MD
- 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.
Abstract
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.
- Copyright ©2004 by the American College of Physicians
