No abstract

Summary Background Mycophenolate mofetil is a commonly used salvage therapy for patients with autoimmune hepatitis (AIH). Aim To evaluate the predictors of response to mycophenolate rescue therapy to facilitate clinical decision making. Methods We performed a retrospective observational cohort study of AIH patients managed in 17 major Australian liver centres who received mycophenolate after an inadequate response or intolerance to corticosteroids with/without thiopurine(s). Baseline demographic, clinical and laboratory variables were compared between responders and nonresponders. A multivariable logistic regression model was developed using forward selection to identify independent predictors of treatment response. Results A total of 105 patients received mycophenolate rescue therapy of whom 63 (60%) achieved biochemical remission. On univariable analysis, older age (P = 0.003), INR < 1.1 (P = 0.02), and lower immunoglobulin gamma (IgG; P < 0.002) levels were associated with treatment response, while no association was found with cirrhosis status (P = 0.07) or treatment indication (P = 0.63). On multivariable analysis, lower pre‐treatment serum IgG level (P = 0.01), higher age at commencing mycophenolate (P = 0.01) and higher INR (P = 0.03) were the only significant independent predictors. An IgG level <17 g/L had a positive and negative predictive value for response of 71% and 60% respectively, while age ≥54 years when commencing mycophenolate had a positive and negative predictive value for response of 80% and 59% respectively. Conclusion Mycophenolate remains an excellent treatment option for patients with AIH refractory to or intolerant of standard therapy with those most likely to benefit being older and/or having lower pre‐treatment IgG levels.

Background: This study aimed to determine the association between dengue infection and monocyte anisocytosis and other Complete Blood Count (CBC) parameters using automatic blood cell analyzer (DxH800) among admitted patients at University of Sto. Tomas Hospital.Methods & Materials: An observational analytic study is done using a hospital-based, 1:1 unmatched case-control study design and enrolling incidents of dengue patients admitted at the University of Sto. Tomas Hospital between October 2012 to September 2013. A dengue infection case is defined as any patient admitted at University of Sto. Tomas Hospital who is found positive to nonstructural protein 1 (NS1) test and a control is defined as any randomly selected admitted patient seen at the laboratory, who is found negative for non-structural protein 1 (NS1) test anytime from October 2012 to September 2013.Results: Adjusting for age and gender of subjects, multivariate analysis using logistic regression showed that monocyte volume≥ 195fL (OR = 4.57, p = 0.0003), monocyte volume standard deviation ≥ 30 fL (OR = 6.99, p = 0.0001), platelet count ≤ 150,000/uL (OR = 4.33, p = 0.0000), and WBC count≤ 2,000/uL (OR = 6.03, 0.0101) are associated with dengue infection. Monocyte percent and mean platelet volume are found to be confounders in the study. Conclusion:There is an association between dengue and monocyte volume standard deviation ≥ 30fL (monocyte anisocytosis), monocyte volume ≥195 fL, platelet ≤150,000/uL and WBC count ≤ 2,000/uL. To further strengthen the finding on the possible association of monocyte volume standard deviation (monocyte anisocytosis) ≥ 30fL and monocyte volume >195 fL, the investigator recommends that clinical information of subjects be included in similar studies that will be conducted in the future.

No abstract

No abstract