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Ann Intern Med 1997 Dec 1;127(11):981-985

Reversibility of hepatic fibrosis in autoimmune hepatitis.

Dufour JF, DeLellis R, Kaplan MM
Department of Pathology, New England Medical Center, Boston, MA 02111, USA.

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 mukat/L to 0.37 mukat/L, the median serum bilirubin level decreased from 70 mumol/L to 10 mumol/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.

PMID: 9412303, UI: 98031967