A practical histological approach to the diagnosis of autoimmune hepatitis: experience of an Italian tertiary referral center.
Adult
Aged
Aged, 80 and over
Apoptosis
Biopsy
Female
Hepatitis, Autoimmune
/ diagnosis
Humans
Italy
Liver
/ immunology
Liver Cirrhosis
/ diagnosis
Male
Middle Aged
Predictive Value of Tests
Prognosis
Referral and Consultation
Reproducibility of Results
Retrospective Studies
Tertiary Care Centers
Time Factors
Apoptosis
Autoimmune hepatitis
Fibrosis
Histopathology
Liver biopsy
Journal
Virchows Archiv : an international journal of pathology
ISSN: 1432-2307
Titre abrégé: Virchows Arch
Pays: Germany
ID NLM: 9423843
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
15
12
2020
accepted:
11
05
2021
revised:
04
05
2021
pubmed:
1
7
2021
medline:
23
11
2021
entrez:
30
6
2021
Statut:
ppublish
Résumé
Liver biopsy is crucial for the diagnosis of autoimmune hepatitis (AIH), and new reproducible histological criteria would be highly desirable, especially in acute-on-chronic cases. The aims of the present study were (i) to evaluate the AIH histopathological criteria as a function of the time and modality of AIH onset, and (ii) to validate the count of apoptotic bodies in the portal tracts as a histopathological criterion for AIH diagnosis. Sixty-five patients were retrospectively enrolled: 20 underwent biopsy for the first diagnosis and 45 had a previous histological AIH diagnosis. Biopsies were revised, and all histological variables were collected, including the lymphocytic apoptotic bodies in the portal tracts. Clinical and serological data were revised as well. First-diagnosis patients showed a higher grade of inflammation (p = 0.001), but also worse portal fibrosis (p = 0.001). The apoptotic body count was higher in first-diagnosis patients than in follow-up patients (p = 0.002), and it was strongly correlated to inflammation. Using the apoptotic body count among the simplified AIH score variables, the first-biopsy patients in the "definite" category rose from 42 to 68%. Our results confirm the histopathological criteria proposed by the literature and introduce the count of portal apoptotic bodies for the diagnosis of active AIH, especially in first biopsies without other classic features, as well as in AIH diagnostic score, albeit future studies are required to find a definite cutoff.
Identifiants
pubmed: 34189631
doi: 10.1007/s00428-021-03122-5
pii: 10.1007/s00428-021-03122-5
pmc: PMC8241564
doi:
Types de publication
Journal Article
Validation Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
937-945Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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