ReviewDigestive diseases and sciences2013
Acute and acute severe (fulminant) autoimmune hepatitis.
Review in Digestive diseases and sciences, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 133 citations in OpenAlex.
- KASL clinical practice guidelines for management of autoimmune hepatitis 2022.Clinical and molecular hepatology · 2023Guideline
- Evaluation of Histological Criteria and Immunoserological Testing of Simplified Criteria for the Diagnosis of Autoimmune Hepatitis.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2025Article
- Article
- Acute presentation of autoimmune hepatitis -from acute hepatitis to ALF and ACLF.Hepatology international · 2024Review
- External validation of the IAIHG autoimmune hepatitis response criteria in a multicentric real-world cohort.JHEP reports : innovation in hepatology · 2024Article
- Clinical Characteristics of Genuine Acute Autoimmune Hepatitis.GE Portuguese journal of gastroenterology · 2024Article
- Article
- [Treatment of Autoimmune Hepatitis].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2023Review
- [Analysis of clinical features and prognosis of acute severe autoimmune hepatitis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2022Article
- Autoimmune Hepatitis with Acute Presentation: Clinical, Biochemical, and Histological Features of 126 Patients.Canadian journal of gastroenterology & hepatology · 2022Article
- Viral Hepatitis and Hepatocellular Carcinoma: State of the Art.Pathogens (Basel, Switzerland) · 2021Review
- Clinical characteristics and treatment outcomes of acute severe autoimmune hepatitis.BMC gastroenterology · 2021Article
- Recent updates on the management of autoimmune hepatitis.Clinical and molecular hepatology · 2021Review
- Infectious complications and timing for liver transplantation in autoimmune acute liver failure in Japan: a subanalysis based on nationwide surveys between 2010 and 2015.Journal of gastroenterology · 2020Article
- Postinfectious Autoimmune Hepatitis-Induced Liver Failure: A Consequence of Hepatitis A Virus Infection.ACG case reports journal · 2020Article
- CLIF-C Organ Failure Score and Liver Volume Predict Prognosis in Steroid-Treated Severe Acute Autoimmune Hepatitis.Hepatology communications · 2020Article
- Autoimmune Hepatitis: Surviving Crises of Doubt and Elimination.Clinical liver disease · 2020Review
- The Saudi association for the study of liver diseases and transplantation clinical practice guidelines for management of autoimmune hepatitis.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2018Article
- Differential Diagnosis of Hepatic Necrosis Encountered at Autopsy.Academic forensic pathology · 2018Review
- Long-term observation of acute-onset autoimmune hepatitis presenting clinically and radiologically as acute hepatitis.Hepatology international · 2018Article
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Autoimmune hepatitis frequently has an abrupt onset of symptoms, and it can present with acute liver failure. The abrupt presentation can indicate spontaneous exacerbation of a pre-existent chronic disease, newly created disease, a superimposed infectious or toxic injury, or new disease after viral infection, drug therapy, or liver transplantation. Deficiencies in the classical phenotype may include a low serum immunoglobulin G level and low or absent titers of the conventional autoantibodies. The original revised diagnostic scoring system of the International Autoimmune Hepatitis Group can guide the diagnostic evaluation, but low scores do not preclude the diagnosis. Liver tissue examination is valuable to exclude viral-related or drug-induced liver injury and support the diagnosis by demonstrating centrilobular necrosis (usually with interface hepatitis), lymphoplasmacytic infiltration, hepatocyte rosettes, and fibrosis. Conventional therapy with prednisone and azathioprine induces clinical and laboratory improvement in 68-75 % of patients with acute presentations, and high dose prednisone or prednisolone (preferred drug) is effective in 20-100 % of patients with acute severe (fulminant) presentations. Failure to improve or worsening of any clinical or laboratory feature within 2 weeks of treatment or worsening of a mathematical model of end-stage liver disease within 7 days justifies liver transplantation in acute liver failure. Liver transplantation for acute severe (fulminant) autoimmune hepatitis is as successful as liver transplantation for autoimmune hepatitis with a chronic presentation and other types of acute liver failure (patient survival >1 year, 80-94 %). Liver transplantation should not be delayed or superseded by protracted corticosteroid therapy or the empiric institution of nonstandard medications.
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