Comparative analysis of clinical and histological features in liver failure due to autoimmune hepatitis with varied prognoses

Abstract

Abstract: Objective To compare the clinical and histological characteristics of autoimmune hepatitis-related liver failure (AIH-LF) across different prognostic outcomes. Methods A total of 150 patients with AIH-LF admitted for treatment between June 2022 and June 2023 were selected for this study. Following standardized treatment, the patients were categorized into a remission group and an ineffective group based on their prognoses. Clinical data and examination results were retrospectively collected, and the clinical and liver histological characteristics were compared between the two groups. Results Based on the prognosis, 74 patients were classified into the remission group, and 76 cases into the ineffective group. In the ineffective group, 42 cases (55.3%) had a disease course exceeding 6 months, 43 cases (56.6%) presented with chronic and acute features, 21 cases (27.6%) experienced bleeding, the AFP level was 112.2 ± 26.3 ng/mL, and the MELD score was 27.54 (23.4, 30.1). The differences between the ineffective group and the remission group were statistically significant (P<0.05). No significant differences were found in the detection rates of serum antibodies ANA, AMA, and P-ANCA between the two groups(P>0.05). However, the detection rates of LKM-1 and SLA/LP were 2 cases (2.7%) and 3 cases (4.1%) in the remission group, respectively, compared to 11 cases(14.5%) and 16 cases (21.1%) in the ineffective group, with statistical significance (P<0.05). When comparing liver histology, the remission group exhibited a higher rate of interfacel hepatitis and F2 phase liver fibrosis compared to the ineffective group (P<0.05). In contrast, the ineffective group had higher rates of portal vein inflammation, bile duct injury, plasma cell infiltration, lobular hepatitis, and rosette formation(P<0.05). Conclusion The clinical and liver histological characteristics of AIH-LF patients vary significantly based on their prognoses. Compared to patients with a favorable prognosis, those with a poor prognosis tend to have a longer course of AIH, more frequent bleeding symptoms, and more severe portal vein inflammation, bile duct injury, and liver fibrosis. These findings provide valuable insights for clinical diagnosis and treatment strategies.

Key words: Autoimmune hepatitis, Different prognoses, Liver failure, Clinical characteristics, Characteristics of liver histology

WANG You-jie, XIE Pei-yu. Comparative analysis of clinical and histological features in liver failure due to autoimmune hepatitis with varied prognoses[J]. Chinese Hepatolgy, 2024, 29(9): 1113-1116.

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