Bone marrow findings in patients with autoimmune liver diseases

Tsikrikoni, Aikaterini; Rigopoulou, Eirini I.; Zachou, Kalliopi; Liaskos, Christos; Kyriakou, Despina; Dalekos, George Ν.

doi:10.1111/j.1440-1746.2008.05309.x

Cited by 6 publications

(7 citation statements)

References 39 publications

(81 reference statements)

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“…The erythrocyte count in peripheral blood may be associated with chronic hepatic injury due to the impairment of the erythrocyte membrane structure caused by alteration of the lipid composition. Furthermore, certain studies suggested that the deficiency of hematopoietic precursors due to immune injury of the hematopoietic system was also linked to a reduced erythrocyte count in patients with PBC (22,23). Other causes of erythrocyte deficiency included malnutrition, iron deficiency, bone marrow depression, cirrhosis and medications (22,24).…”

Section: A Baselinementioning

confidence: 99%

Erythrocyte count is associated with prognosis in Chinese patients with primary biliary cholangitis

Chang

Guo

et al. 2020

Exp Ther Med

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Erythroid parameters have been indicated to be important prognostic factors for liver diseases. The present study aimed to evaluate the prognostic value of the erythrocyte count in Chinese patients with primary biliary cholangitis (PBC) and develop a prognostic model. The clinical data of 301 patients with PBC were retrospectively reviewed. Univariate and multivariate Cox regression analysis was performed to identify potential prognostic risk factors. Bivariate correlation analysis was used to determine the correlation coefficient of the erythrocyte count and biochemical indices. The prognostic values of different factors were compared by receiver operating characteristic (ROC) curve analysis. A novel prognostic model was constructed using multivariate logistic regression. Multivariate regression analysis suggested that the erythrocyte count was an independent risk factor/prognostic index (P=0.042). The erythrocyte count in peripheral blood decreased as the histological stage progressed (P<0.001). The erythrocyte count was correlated with albumin, liver stiffness and Fibrosis-4. Compared with that of platelets, the area under the ROC curve of the erythrocyte count was significantly greater. A similar area under the ROC curve was determined for the erythrocyte count, albumin and total bilirubin (P>0.05). A novel prognostic model was established as follows: P=1/{1 + e-[6. 140-3.193 x Ln(erythrocyte count) -0.184 x albumin + 0.827 x Ln(total bilirubin)]}. The novel model had a comparable prognostic value to that of the GLOBE score and UK-PBC risk score, and had a better performance than the Mayo risk score at baseline (0.838 vs. 0.787). In conclusion, the erythrocyte count is an independent risk factor/prognostic index in Chinese patients with PBC. It was correlated with liver function and fibrosis in Chinese patients. The novel model incorporating the erythrocyte count and biochemical indices at baseline may serve as a prognostic tool in Chinese patients with PBC (Trial registration number,

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Section: A Baselinementioning

confidence: 99%

Erythrocyte count is associated with prognosis in Chinese patients with primary biliary cholangitis

Chang

Guo

et al. 2020

Exp Ther Med

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“…As detailed in our previous reports [11,[30][31][32][33], the diagnosis of PBC was based on the presence of at least two of the following criteria: (a) positivity for AMA (positive titer !1/40) either by IIF on in-house fresh rodent tissue substrates confirmed by Western blot using in-house mitochondrial subtraction of rat livers, or by enhanced performance M2 ELISA (M2 EP (MIT3) ELISA, QUANTA Lite Õ , INOVA Diagnostics, San Diego, CA), which was shown to have higher sensitivity compared to the conventional anti-M2 [11], (b) elevated cholestatic enzymes for more than 6 months, and (c) histological lesions of PBC. Other causes of cholestasis, history of alcohol abuse, infections with hepatitis B, C and D viruses, Wilson disease and haemochromatosis were appropriately excluded.…”

Section: Patientsmentioning

confidence: 99%

Clinical significance of the fluctuation of primary biliary cirrhosis-related autoantibodies during the course of the disease

et al. 2013

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Primary biliary cirrhosis (PBC) is a chronic cholestatic disease characterized by the presence of antimitochondrial antibodies (AMA). PBC-specific antinuclear antibodies (ANA) have been characterized and associated with disease progression and outcome. We evaluated the clinical significance of the presence and serial changes in titers of AMA, PBC-specific ANA (anti-gp210, anti-sp100) and anti-chromatin antibodies. Over a median (IQR) period of 35 (36) months, 512 specimens were collected from 110 patients. Autoantibodies were detected by commercial ELISAs (INOVA Diagnostics). Biochemical, clinical, and histological status were included at initial presentation and during follow-up visits. The Mayo risk score was calculated as a prognostic index at each time point. Liver biopsy findings were classified according to Ludwig's classification and biochemical response to ursodeoxycholic acid was evaluated according to Pares. At baseline, AMA IgG and IgA, anti-gp210 IgG, anti-sp100 IgG and anti-chromatin IgG were detected in 92/110 (83.6%), 57/110 (51.8%), 5/110 (4.5%), 14/110 (12.7%), and 0/110 (0%) patients, respectively. Positivity for all autoantibodies apart from anti-chromatin, at baseline visit (n = 110 patients), in all tested sera (n = 512) as well as increased autoantibodies titers during follow-up were associated with biochemically and/or histologically advanced disease. A decrease of anti-sp100 titers but not of anti-gp210 titers during follow-up was associated with improvement of Mayo risk score (p = 0.025) and response to ursodeoxycholic acid (p = 0.016). These results suggest that detection of AMA and PBC-specific ANA was correlated with disease severity. Serial changes of anti-sp100 titers and not of anti-gp210 titers might prove useful for monitoring the disease course and treatment outcome.

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“…Autologous haemopoietic stem cell transplantation and mesenchymal stem cell transplantation could be other options for treating patients with severe and/or refractory forms of the disease. Such a therapeutic option for AIH and other autoimmune diseases has already been reportedand supported by findings indicating that bone marrow from patients with AIH have had increased numbers of haemopoietic progenitor cells and plasma cells, whereas bone marrow stromal cells supported normal haemopoiesis . In addition, bone marrow cultures have shown high levels of apoptotic markers, tumour necrosis factor‐alpha (TNF‐alpha), interferon‐gamma, IL‐4 and TGF‐beta .…”

Section: Management and Outcomementioning

confidence: 99%

Review article: autoimmune hepatitis - current management and challenges

Zachou

Muratori

Koukoulis³

et al. 2013

Aliment Pharmacol Ther

172

202

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SUMMARY BackgroundAutoimmune hepatitis (AIH) is a disease of unknown aetiology characterised by interface hepatitis, hypergammaglobulinaemia, circulating autoantibodies and a favourable response to immunosuppression. AimTo review recent advancements in understanding aetiopathogenesis, clinical, serological and histological features, diagnostic criteria and treatment strategies of AIH. MethodsPublished studies on AIH extracted mainly from PubMed during the last 15 years. ResultsAutoimmune hepatitis has a global distribution affecting any age, both sexes and all ethnic groups. Clinical manifestations are variable ranging from no symptoms to severe acute hepatitis and only seldom to fulminant hepatic failure. Autoimmune attack is perpetuated, possibly via molecular mimicry mechanisms, and favoured by the impaired control of regulatory T-cells. A typical laboratory finding is hypergammaglobulinaemia with selective elevation of IgG, although in 15-25% of patients -particularly children, elderly and acute cases -IgG levels are normal. Liver histology and autoantibodies, although not pathognomonic, still remain the hallmark for diagnosis. Immunosuppressive treatment is mandatory and life-saving; however, to meet strict response criteria, the conventional therapy with prednisolone with or without azathioprine is far from ideal. ConclusionsAutoimmune hepatitis remains a major diagnostic and therapeutic challenge. The clinician, the hepato-pathologist and the laboratory personnel need to become more familiar with different expressions of the disease, interpretation of liver histology and autoimmune serology. According to the strict definition of treatment response issued by the 2010 AASLD guidelines, many patients are nonresponders to conventional treatment. Newer immunosuppressive agents targeting pathogenetic mechanisms can improve patient management, which needs to be tailored on a case-by-case basis.

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Bone marrow findings in patients with autoimmune liver diseases

Cited by 6 publications

References 39 publications

Erythrocyte count is associated with prognosis in Chinese patients with primary biliary cholangitis

Erythrocyte count is associated with prognosis in Chinese patients with primary biliary cholangitis

Clinical significance of the fluctuation of primary biliary cirrhosis-related autoantibodies during the course of the disease

Review article: autoimmune hepatitis - current management and challenges

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