Prevalence and significance of antimitochondrial antibodies in autoimmune hepatitis (AIH): Results from a large multicentre study of the International AIH Group

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2
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
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ELSEVIER
Autores
GATSELIS, Nikolaos K.
ZACHOU, Kalliopi
LOZA, Aldo J. Montano
ARINAGA-HINO, Teruko
MURATORI, Paolo
EFE, Cumali
FLOREANI, Annarosa
INVERNIZZI, Pietro
TAKAHASHI, Athushi
Citação
EUROPEAN JOURNAL OF INTERNAL MEDICINE, v.116, p.43-50, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background & Aims: Antimitochondrial antibodies (AMA) are specific markers for the diagnosis of primary biliary cholangitis (PBC) but can also be found occasionally in patients with autoimmune hepatitis (AIH). The present large multicentre cohort study assessed the prevalence and significance of AMA in AIH-patients. Methods: 123 AMA-positive AIH-patients were investigated and compared with 711 age-matched AMA-negative AIH-patients and 69 patients with AIH/PBC variant. Results: AMA prevalence in AIH-patients was 5.1% (range: 1.2%-11.8%). AMA-positivity was associated with female sex (p = 0.031) in AMA-positive AIH-patients but not with liver biochemistry, bile duct injury on liver biopsy, disease severity at baseline and response to treatment compared to AMA-negative AIH-patients. Comparing AMA-positive AIH-patients to those with AIH/PBC variant, there was no difference in disease severity. Regarding liver histology, AIH/PBC variant patients were characterized by the presence of at least one feature of bile duct damage (p<0.001). Response to immunosuppressive treatment was similar among groups. From AMA-positive AIH patients only those with evidence of non-specific bile duct injury had higher risk to progress to cirrhosis (HR=4.314, 95%CI: 2.348-7.928; p<0.001). During follow-up, AMA-positive AIH-patients had higher risk to develop histological bile duct injury (HR 4.654, 95%CI 1.829-11.840; p = 0.001). Conclusions: AMA presence is relatively common among AIH-patients, but their clinical significance seems important only when they co-exist with non-specific bile duct injury at the histological level. Therefore, a careful evaluation of liver biopsy seems of utmost importance in these patients.
Palavras-chave
Autoimmune hepatitis, Primary biliary cholangitis, Autoantibodies, Autoimmune hepatitis/primary biliary, cholangitis variant syndrome, Antimitochondrial antibodies, Outcome
URI
https://observatorio.fm.usp.br/handle/OPI/58879
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MGT