Evidence map›Paper›PMID 29632422›Full record

ArticleWorld journal of gastroenterology2018

Potential triggering factors of acute liver failure as a first manifestation of autoimmune hepatitis-a single center experience of 52 adult patients.

Matthias Buechter, Paul Manka, Falko Markus Heinemann, Monika Lindemann, Hideo Andreas Baba, Martin Schlattjan, Ali Canbay, Guido Gerken, Alisan Kahraman

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Autoimmune Hepatitis-Challenging Diagnosis.Medicina (Kaunas, Lithuania) · 2022
    Article
  5. Review
  6. Approach to the patient with acute severe autoimmune hepatitis.JHEP reports : innovation in hepatology · 2020
    Review
  7. Review
  8. Article
  9. Article
  10. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Matthias BuechterDepartment of Gastroenterology and Hepatology, University Clinic of Essen, Essen 45147, Germany.
Paul MankaDepartment of Gastroenterology and Hepatology, University Clinic of Essen, Essen 45147, Germany.
Falko Markus HeinemannInstitute of Transfusion Medicine, University Clinic of Essen, Essen 45147, Germany.
Monika LindemannInstitute of Transfusion Medicine, University Clinic of Essen, Essen 45147, Germany.
Hideo Andreas BabaInstitute of Pathology, University Clinic of Essen, Essen 45147, Germany.
Martin SchlattjanInstitute of Pathology, University Clinic of Essen, Essen 45147, Germany.
Ali CanbayDepartment of Gastroenterology, Hepatology, and Infectious Diseases, Otto-von-Guericke University, Magdeburg 39120, Germany.
Guido GerkenDepartment of Gastroenterology and Hepatology, University Clinic of Essen, Essen 45147, Germany.
Alisan KahramanDepartment of Gastroenterology and Hepatology, University Clinic of Essen, Essen 45147, Germany. alisan.kahraman@uk-essen.de.
King's College London · GBOtto-von-Guericke University Magdeburg · DEEssen University Hospital · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo investigate potential triggering factors leading to acute liver failure (ALF) as the initial presentation of autoimmune hepatitis (AIH).

methodsA total of 565 patients treated at our Department between 2005 and 2017 for histologically-proven AIH were retrospectively analyzed. However, 52 patients (9.2%) fulfilled the criteria for ALF defined by the "American Association for the Study of the Liver (AASLD)". According to this definition, patients with "acute-on-chronic" or "acute-on-cirrhosis" liver failure were excluded. Following parameters with focus on potential triggering factors were evaluated: Patients' demographics, causation of liver failure, laboratory data (liver enzymes, MELD-score, autoimmune markers, virus serology), liver histology, immunosuppressive regime, and finally, outcome of our patients.

resultsThe majority of patients with ALF were female (84.6%) and mean age was 43.6 ± 14.9 years. Interestingly, none of the patients with ALF was positive for anti-liver kidney microsomal antibody (LKM). We could identify potential triggering factors in 26/52 (50.0%) of previously healthy patients presenting ALF as their first manifestation of AIH. These were drug-induced ALF (57.7%), virus-induced ALF (30.8%), and preceding surgery in general anesthesia (11.5%), respectively. Unfortunately, 6 out of 52 patients (11.5%) did not survive ALF and 3 patients (5.7%) underwent liver transplantation (LT). Comparing data of survivors and patients with non-recovery following treatment, MELD-score (

conclusionDrugs, viral infections, and previous surgery may trigger ALF as the initial presentation of AIH. Advanced age and high MELD-score were associated with lethal outcome.

Indexed as

AdultAgedAge FactorsAutoimmunityBiomarkersCreatinineFemaleHepatitis, AutoimmuneHumansImmunosuppressive AgentsLaparoscopyLiverLiver Failure, AcuteLiver Function TestsLiver TransplantationMaleBiomarkersCreatinineImmunosuppressive AgentsAcute liver failureAutoimmune hepatitisDrug-induced liver injuryMELD-scoreTriggering factors

Identifiers

PMID29632422
PMCPMC5889821
OpenAlexW2796138640

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.