Autoimmune Hepatitis: Single-center Experience of Clinical Presentation, Response to Treatment and Prognosis in Saudi Arabia

Fallatah, Hind I.; Akbar, Hisham O.; Qari, Yousif A.
April 2010
Saudi Journal of Gastroenterology;Apr2010, Vol. 16 Issue 2, p95
Academic Journal
Background/Aim: Autoimmune hepatitis (AIH) is a common cause of end-stage liver disease worldwide. It is a disease prevalent in children and adults, with female predominance and variable clinical presentations. AIH has favorable responses to steroids and immunomodulators. Diagnosis of AIH is based on clinical and laboratory criteria, as suggested by the International Autoimmune Hepatitis Group. Data on the disease pattern of AIH from the Middle East countries is scarce. Materials and Methods: In this retrospective analysis, we studied clinical and laboratory features, immunological data, radiological findings, liver biopsy findings and response to therapy in patients with AIH from the hepatology clinics of King Abdul Aziz, University Hospital, Jeddah, from 1994 to 2008. Results: We diagnosed 41 patients with AIH, and 33 were included in the analysis. The mean age was 32.3 years, with female predominance of 75.7%. Decompensated cirrhosis at presentation was found in 45.5% of the patients. Acute hepatitis was associated with significantly higher levels of the serum ALT and bilirubin (P=0.001 and P=0.03, respectively). All our patients had type 1 AIH. Treatment with prednisolone and azathioprine resulted in complete or partial remission in majority of the patients (54.8%). However, patients with advanced disease showed a poorer response to treatment (P=0.016). Six patients with poor compliance had relapse of AIH. Two patients had a flare of the disease during pregnancy, and they responded well with prednisolone. The longest follow-up was 14 years and the shortest was 2 months. Four patients died from liver disease. Conclusion: AIH patients in Saudi Arabia are likely to present with advanced disease at a young age and would have a poorer response to therapy as compared with patients in other countries worldwide.


Related Articles

  • Efficacy of early immunomodulator therapy on the outcomes of Crohn's disease. Min Seob Kwak; Duk Hwan Kim; Soo Jung Park; Tae Il Kim; Sung Pil Hong; Won Ho Kim; Jae Hee Cheon // BMC Gastroenterology;2014, Vol. 14 Issue 1, p1 

    Background The natural course of Crohn's disease (CD), with continuing relapses and remissions, leads to irreversible intestinal damage. Early adoption of immunomodulator therapy has been proposed in order to address this; however, it is still uncertain whether early immunomodulator therapy...

  • Relapsing-Remitting Multipl Skleroz Hastalarında Glatiramer Asetat Deneyimi. Taşkapılıoğlu, zlem; Bahar Turan, Aslı; Albas, Murat; Faruk Turan, mer // Turkish Journal of Neurology / Turk Noroloji Dergisi;Mar2012, Vol. 18 Issue 1, p17 

    Objective: Glatiramer acetate (GA) has been shown to reduce the number of relapses and improve outcomes in relapsing-remitting multiple sclerosis (RRMS) patients. The aim of this study is to investigate the efficacy and side effects of GA in RRMS patients treated with it. Material and Method: We...

  • Refractory Autoimmune Hepatitis: Beyond Standard Therapy. Rubin, Jonah; Te, Helen; Rubin, Jonah N; Te, Helen S // Digestive Diseases & Sciences;Jun2016, Vol. 61 Issue 6, p1757 

    Autoimmune hepatitis (AIH) can be difficult to control, particularly in some African-Americans. When standard therapy of prednisone and azathioprine is ineffective or poorly tolerated, alternative therapies are resorted to. We report two patients with AIH who were refractory to or intolerant of...

  • May Oxidative Stress Contribute to Autoimmune Hepatitis Pathogenesis, and Can Antioxidants Be of Value as Adjuvant Therapy for Refractory Patients? Moreno-Otero, Ricardo // Digestive Diseases & Sciences;May2013, Vol. 58 Issue 5, p1440 

    No abstract available.

  • Cyclosporine Induced Biochemical Remission in Childhood Autoimmune Hepatitis. Franulović, Orjena žaja; Rajačić, Nada; Lesar, Tatjana; Kuna, Andrea Tešija; Morić, Bernardica Valent // Collegium Antropologicum;Sep2012, Vol. 36 Issue 3, p973 

    The conventional treatment of autoimmune hepatitis (AIH) in children, which includes prednisone alone or in combi-nation with azathioprine, induces remission in most cases but is often associated with poorly tolerated side effects. To avoid the adverse effects, Alvarez et al. introduced an...

  • Advances in the Current Treatment of Autoimmune Hepatitis. Czaja, Albert // Digestive Diseases & Sciences;Aug2012, Vol. 57 Issue 8, p1996 

    Current treatment strategies for autoimmune hepatitis are complicated by frequent relapse after drug withdrawal, medication intolerance, and refractory disease. The objective of this review is to describe advances that have improved treatment outcomes by defining the optimum objectives of...

  • Cyclosporine-A Versus Prednisolone for Induction of Remission in Auto-immune Hepatitis: Interim Analysis Report of a Randomized Controlled Trial. Nasseri-Moghaddam, Siavosh; Nikfam, Sepideh; Karimian, Saied; Khashayar, Patricia; Malekzadeh, Reza // Middle East Journal of Digestive Diseases;Oct2013, Vol. 5 Issue 4, p193 

    BACKGROUND Corticosteroids are used to induce remission in auto-immune hepatitis. They are not universally effective; therefore, alternative treatments are needed. In this study Cysclosporine-A has been compared with prednisolone as an alternative treatment in a randomized controlled trial. This...

  • Mycophenolate Mofetil as Second Line Therapy in Autoimmune Hepatitis? Hennes, Elke M.; Oo, Ye H.; Schramm, Christoph; Denzer, Ulrike; Buggisch, Peter; Wiegard, Christiane; Kanzler, Stephan; Schuchmann, Marcus; Boecher, Wulf; Galle, Peter R.; Adams, David H.; Lohse, Ansgar W. // American Journal of Gastroenterology;Dec2008, Vol. 103 Issue 12, p3063 

    INTRODUCTION: In patients with autoimmune hepatitis, efficient immunosuppressive therapy is essential to avoid progression to cirrhosis. There is no established second line therapy for patients failing standard therapy with steroids and azathioprine. The aim of this study was to examine the...

  • Azathioprine for Long-Term Maintenance of Remission in Autoimmune Hepatitis. Johnson, Philip J.; McFarlane, Ian G.; Williams, Roger // New England Journal of Medicine;10/12/95, Vol. 333 Issue 15, p958 

    Background: In most patients with autoimmune hepatitis, remission can be maintained with prednisolone, usually in combination with azathioprine, but the majority of patients have a relapse when treatment is stopped and therefore require long-term therapy. Because prolonged corticosteroid therapy...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics