Background: Epidemiological studies of autoimmune hepatitis are scarce and often based on single centre registries. Aims: We conducted a nationwide register study of incidence, prevalence, survival, and causes of death of autoimmune hepatitis patients in Finland. Methods: Autoimmune hepatitis cases 1995-2015 were retrieved from the national database of special reimbursements for drugs costs. Data on causes of death were retrieved from Statistics Finland. Results: After incomplete registration of AIH during the first years, the incidence of autoimmune hepatitis stabilised to 1.1/100,000 person-years (1.6 in women and 0.52 in men) in 2008-2015. The prevalence of autoimmune hepatitis at the end of 2015 was 14.3/100,000, 23.0/100,000 in women and 6.6/100,000 in men. The all-cause standardized mortality ratio (SMR) of autoimmune hepatitis patients was 1.81 (95% confidence interval (CI) 1.47-2.20). The SMR was increased in all age groups and in both sexes. The SMR for hepatocellular carcinoma was 20.6 (95% CI 10.3-36.8), and for digestive diseases in overall 13.5 (95% CI 8.2-20.8), constituting mainly from autoimmune hepatitis and liver cirrhosis. Conclusion: Incidence of autoimmune hepatitis has remained stable, with clear female predominance. Autoimmune hepatitis is associated with a markedly increased risk of death with hepatocellular cancer forming the greatest risk.

BACKGROUND AND STUDY AIMS: Motorized spiral enteroscopy (MSE) has been shown to be safe and effective for deep enteroscopy in studies with limited numbers of patients without previous abdominal surgery at expert centers. Aim of this study was to investigate the safety, efficacy, and learning curve associated with MSE in a real-life scenario with inclusion of patients after abdominal surgery and with altered anatomy. PATIENTS AND METHODS: Patients with indications for deep enteroscopy were enrolled in a prospective observational multicenter study. Primary objective: serious adverse event rate (SAE); Secondary objectives: diagnostic and therapeutic yield, procedural success, time, insertion depth. Data analysis was subdivided into training and core (post-training) study phases at centers with different levels of MSE experience. RESULTS: Two hundred ninety-eight patients (120 females; median age 68 years; 19-92) were enrolled. 21.5% (n=54) had previous abdominal surgery, 10.0% (n=25) had surgically altered anatomy. Overall, SAEs occurred in 2.3% (7/298) 95%CI 0.9%-4.8%. The SAE rate was 2.0% (5/251) in the core group and 4.3% (2/47) in the training group and was not increased after abdominal surgery (1.9%). Total enteroscopy was achieved in half of the patients with planned total enteroscopy (n=42). In 295/337 procedures (87.5%) the anatomical region of interest could be reached. CONCLUSIONS: This prospective multicenter study showed that MSE was feasible and safe in a large cohort of patients in a real-life setting after a short learning curve. MSE was shown to be feasible in postsurgical patients and patients with altered anatomy without AE rate increase. NCT03955081 (clinicaltrials.gov)

The efficacy of rhGH treatment is sustained after the first year in liver-transplant children with non-GH-deficient growth retardation. Because of a potential risk of side effects, close monitoring of these patients is required.