Etiopathogenesis and Diagnostic Strategies in Autoimmune Hepatitis

So far, the literature data have presented a combination of several autoimmune triggered disease in patients, but the research is scarce and very limited. In this context we present a rare case of autoimmune thyroiditis with a concomitant autoimmune hepatitis. Hashimoto thyroiditis is an autoimmune disorder in which immune cells lead to impairment, destruction of the thyroid hormone producing cells and tissue fibrosis with consecutive primary hypothyroidism. Autoimmune hepatitis is a chronic liver disease with unknown etiology, which is assumed to be T cell mediated condition where immune cells produce autoantibodies responsible for inflammation, destruction and fibrosis of the hepatic parenchyma. In this case report, we discuss the possible correlation in the spectrum of autoimmune diseases concerning Hashimoto thyroiditis and autoimmune hepatitis.

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“…Autoimmune hepatitis is an inflammatory condition of the liver with However, testing for ANA antibodies is necessary for AIH diagnosis 12 .…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Hashimoto thyroiditis with concomitant autoimmune hepatitis

Manevska

Stojkovska²,

Tasheva³

et al. 2022

Arch Pub Health

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“…ZN-AIH and normal AIH have different inflammation heads, and further research is needed on the cause. [3,28]…”

Section: Discussionmentioning

confidence: 99%

“…ZN-AIH and normal AIH have different inflammation heads, and further research is needed on the cause. [3,28] In this study, the significance of CZN-AIH compared with control AIH was more strongly clarified by subdividing the patients in onset pattern, presence of significant interface hepatitis. Moreover, this is the first report to mention relapse rate of CZN-AIH.…”

Section: Ueda Et Al • Medicine (2022) Medicinementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Typical AIH, a chronic progressive disease, is characterized by presence of antinuclear antibodies (ANA), increased serum immunoglobulin G (IgG), excellent response to immunosuppressive therapy, and the histological feature of moderate to severe (significant) interface hepatitis. [1][2][3] In contrast, acute-onset AIH often lacks both detectable ANA and the increased IgG. [4,5] A minor proportion of AIH cases (17.5%-29%), regardless of acute or chronic state or extent of interface hepatitis, present the histological feature of centrilobular zonal necrosis (CZN).…”

Section: Introductionmentioning

confidence: 99%

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Centrilobular zonal necrosis is a unique subtype of autoimmune hepatitis: A cohort study

et al. 2022

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Backgrounds: Centrilobular zonal necrosis (CZN) is described as a histological feature present in a small number of autoimmune hepatitis (CZN-AIH) patients. CZN may be detected in the absence of significant interface hepatitis, which is the most important histological finding of AIH. The clinical and histopathological spectra of CZN-AIH were not homogeneous, and the concept of CZN-AIH as a distinctive subtype of AIH remains controversial, due to the rarity of CZN-AIH and the ambiguous definition of CZN. Methods: To elucidate the clinical and immunogenetic features of CZN-AIH, a total of 102 biopsy samples of AIH, obtained at The Jikei University Katsushika Medical Center and Jikei University Hospital from 2000 to 2018, were reviewed. The 32 patients whose biopsies showed CZN were selected as the CZN-AIH group, and the remaining 70 were grouped as the non-CZN-AIH controls (control AIH). Data on clinical, histopathologic, and immunogenetic features were statistically compared between the CZN-AIH and the control AIH group. Additionally, the impact of the onset pattern (acute or chronic) and coexistent significant interface hepatitis in CZN-AIH was determined. Results: In CZN-AIH, the frequency of acute-onset cases was significantly higher than that in control AIH (56.2% vs 32.9%; P < .05), and the number of cases with moderate-to-severe interface hepatitis in liver histology was significantly lower (37.5% vs 87.1%; P < .001). Compared to the control AIH, cases of CZN-AIH had lower immunoglobulin G level (P < .001), lower antinuclear antibodies titer (P < .001), and lower AIH score (P < .001). The immunogenetic disproportionate distribution of HLA-DR phenotypes in control AIH (increased HLA-DR4 and decreased HLA-DR9) was not found in CZN-AIH. Moreover, CZN-AIH was less frequently relapsed (P < .05). For the acute-onset CZN-AIH cases, the clinical features were hardly indistinguishable from the chronic CZN-AIH cases. Similarly, the existence of interface hepatitis did not influence on the pathophysiology of CZN-AIH. Moreover, the acute-onset CZN-AIH cases is clinically distinguishable from acute-onset control AIH Conclusion: CZN can characterize as a distinct AIH subtype, regardless of onset-pattern or coexistence of significant interface hepatitis. To further strengthen this hypothesis, collection of more CZN-AIH cases is needed.

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Characteristics of peripheral blood mononuclear cells and potential related molecular mechanisms in patients with autoimmune hepatitis: a single-cell RNA sequencing analysis

Abe,

Sugaya

et al. 2024

Med Mol Morphol

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Etiopathogenesis and Diagnostic Strategies in Autoimmune Hepatitis

Cited by 6 publications

References 125 publications

Autoimmune Hashimoto thyroiditis with concomitant autoimmune hepatitis

Autoimmune Hashimoto thyroiditis with concomitant autoimmune hepatitis

Centrilobular zonal necrosis is a unique subtype of autoimmune hepatitis: A cohort study

Characteristics of peripheral blood mononuclear cells and potential related molecular mechanisms in patients with autoimmune hepatitis: a single-cell RNA sequencing analysis

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