Loading…
Concurrent extrahepatic autoimmunity in autoimmune hepatitis: implications for diagnosis, clinical course and long‐term outcomes
Background Concurrent extrahepatic autoimmune disease (CEHAID) associated with autoimmune hepatitis (AIH) have been incorporated into the diagnostic criteria stipulated by the International Autoimmune Hepatitis Group (IAIHG). Large comprehensive cohort data on the extrahepatic autoimmunity in AIH re...
Saved in:
| Published in: | Liver international 2017-03, Vol.37 (3), p.449-457 |
|---|---|
| Main Authors: | , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c3886-96337c92eb143d6204cd0112676e65f6cc8145ab1c8749be1c556c4135e6be683 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c3886-96337c92eb143d6204cd0112676e65f6cc8145ab1c8749be1c556c4135e6be683 |
| container_end_page | 457 |
| container_issue | 3 |
| container_start_page | 449 |
| container_title | Liver international |
| container_volume | 37 |
| creator | Wong, Guan‐Wee Yeong, Tian Lawrence, David Yeoman, Andrew D. Verma, Sumita Heneghan, Michael A. |
| description | Background
Concurrent extrahepatic autoimmune disease (CEHAID) associated with autoimmune hepatitis (AIH) have been incorporated into the diagnostic criteria stipulated by the International Autoimmune Hepatitis Group (IAIHG). Large comprehensive cohort data on the extrahepatic autoimmunity in AIH remain scanty.
Aim
To systematically assess features and clinical impact of CEHAID on AIH.
Methods
Clinical records of 562 patients with AIH from two tertiary centres in the UK were retrospectively reviewed.
Results
Prevalence of CEHAID in patients with AIH was 42%. Autoimmune thyroid disease was the commonest CEHAID associated with AIH (101/562, 18%). Autoimmune skin diseases were more prevalent in AIH‐2 than AIH‐1 (21.9% vs 7%, P=.009). Personal history of CEHAID was more commonly found in AIH patients with than without first‐degree family history of CEHAID [48/86 (55.8%) vs 169/446 (37.9%), P=.002]. AIH patients with CEHAID were more often women (85.2% vs 76.1%, P=.008), had higher post‐treatment IAIHG score (22 vs 20, P |
| doi_str_mv | 10.1111/liv.13236 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1859723284</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1920528549</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3886-96337c92eb143d6204cd0112676e65f6cc8145ab1c8749be1c556c4135e6be683</originalsourceid><addsrcrecordid>eNp1kcuKFTEQhoMozkUXvoAE3MyAZ6Yrt07Pbjh4GTjgRt2GdLrOmKE7OSZp9ezEJ_AZfRKjPY4gWJuqn_r4qeIn5Ak0Z1DrfPSfzoAzru6RQxCtXtUZ7t_NjB-Qo5xvmga6TsJDcsBaKaBR_JB8W8fg5pQwFIpfSrIfcGeLd9TOJfppmoMve-rDX410QYrPF9RPu9G7qmLIdBsTHby9DjH7_Jy60Ye6G6mLc8pIbRjoGMP1j6_fC6aJxrm4OGF-RB5s7Zjx8W0_Ju9evni7fr3avHl1tb7crBzXWq06xXnrOoY9CD4o1gg3NABMtQqV3CrnNAhpe3C6FV2P4KRUTgCXqHpUmh-Tk8V3l-LHGXMxk88Ox9EGjHM2oGXXMs60qOizf9Cb-kOo1xnoWCOZlqKr1OlCuRRzTrg1u-Qnm_YGGvMrGFODMb-DqezTW8e5n3C4I_8kUYHzBfjsR9z_38lsrt4vlj8BvQaaWg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1920528549</pqid></control><display><type>article</type><title>Concurrent extrahepatic autoimmunity in autoimmune hepatitis: implications for diagnosis, clinical course and long‐term outcomes</title><source>Wiley:Jisc Collections:Wiley Read and Publish Open Access 2024-2025 (reading list)</source><creator>Wong, Guan‐Wee ; Yeong, Tian ; Lawrence, David ; Yeoman, Andrew D. ; Verma, Sumita ; Heneghan, Michael A.</creator><creatorcontrib>Wong, Guan‐Wee ; Yeong, Tian ; Lawrence, David ; Yeoman, Andrew D. ; Verma, Sumita ; Heneghan, Michael A.</creatorcontrib><description>Background
Concurrent extrahepatic autoimmune disease (CEHAID) associated with autoimmune hepatitis (AIH) have been incorporated into the diagnostic criteria stipulated by the International Autoimmune Hepatitis Group (IAIHG). Large comprehensive cohort data on the extrahepatic autoimmunity in AIH remain scanty.
Aim
To systematically assess features and clinical impact of CEHAID on AIH.
Methods
Clinical records of 562 patients with AIH from two tertiary centres in the UK were retrospectively reviewed.
Results
Prevalence of CEHAID in patients with AIH was 42%. Autoimmune thyroid disease was the commonest CEHAID associated with AIH (101/562, 18%). Autoimmune skin diseases were more prevalent in AIH‐2 than AIH‐1 (21.9% vs 7%, P=.009). Personal history of CEHAID was more commonly found in AIH patients with than without first‐degree family history of CEHAID [48/86 (55.8%) vs 169/446 (37.9%), P=.002]. AIH patients with CEHAID were more often women (85.2% vs 76.1%, P=.008), had higher post‐treatment IAIHG score (22 vs 20, P<.001), less reactivity to smooth muscle antibodies (49.8% vs 65%, P<.001), more likely to have mild fibrosis at diagnosis (20.9% vs 6.5%, P<.001) and less often had ascites (6.3% vs 13.6%, P=.008) and coagulopathy (1.18 vs 1.27, P=.013) at presentation. Presence of CEHAID, however, did not significantly affect disease progression, prognosis and survival in AIH.
Conclusions
Our study confirms the strong association of CEHAID with AIH. Association between personal and familial extrahepatic autoimmunity especially among first‐degree relatives was evident. Presence of CEHAID may influence clinical phenotype of AIH at presentation, but without notable impact on the long‐term clinical outcomes.</description><identifier>ISSN: 1478-3223</identifier><identifier>EISSN: 1478-3231</identifier><identifier>DOI: 10.1111/liv.13236</identifier><identifier>PMID: 27541063</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies ; Ascites ; Autoantibodies - blood ; Autoimmune Diseases - classification ; Autoimmune Diseases - epidemiology ; autoimmune skin disease ; autoimmune thyroiditis ; Child ; Child, Preschool ; Databases, Factual ; Diagnosis ; Diagnostic systems ; Disease ; Disease Progression ; extrahepatic autoimmune diseases ; Family Health ; family history ; Female ; Fibrosis ; first‐degree relatives ; Genetics ; Hepatitis ; Hepatitis, Autoimmune - complications ; Humans ; Liver ; Male ; Medical prognosis ; Middle Aged ; Patients ; Prognosis ; Retrospective Studies ; Risk Factors ; Skin diseases ; Smooth muscle ; Survival Analysis ; Tertiary Care Centers ; Thyroid ; United Kingdom - epidemiology ; Young Adult</subject><ispartof>Liver international, 2017-03, Vol.37 (3), p.449-457</ispartof><rights>2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><rights>2017 John Wiley & Sons A/S</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3886-96337c92eb143d6204cd0112676e65f6cc8145ab1c8749be1c556c4135e6be683</citedby><cites>FETCH-LOGICAL-c3886-96337c92eb143d6204cd0112676e65f6cc8145ab1c8749be1c556c4135e6be683</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27541063$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wong, Guan‐Wee</creatorcontrib><creatorcontrib>Yeong, Tian</creatorcontrib><creatorcontrib>Lawrence, David</creatorcontrib><creatorcontrib>Yeoman, Andrew D.</creatorcontrib><creatorcontrib>Verma, Sumita</creatorcontrib><creatorcontrib>Heneghan, Michael A.</creatorcontrib><title>Concurrent extrahepatic autoimmunity in autoimmune hepatitis: implications for diagnosis, clinical course and long‐term outcomes</title><title>Liver international</title><addtitle>Liver Int</addtitle><description>Background
Concurrent extrahepatic autoimmune disease (CEHAID) associated with autoimmune hepatitis (AIH) have been incorporated into the diagnostic criteria stipulated by the International Autoimmune Hepatitis Group (IAIHG). Large comprehensive cohort data on the extrahepatic autoimmunity in AIH remain scanty.
Aim
To systematically assess features and clinical impact of CEHAID on AIH.
Methods
Clinical records of 562 patients with AIH from two tertiary centres in the UK were retrospectively reviewed.
Results
Prevalence of CEHAID in patients with AIH was 42%. Autoimmune thyroid disease was the commonest CEHAID associated with AIH (101/562, 18%). Autoimmune skin diseases were more prevalent in AIH‐2 than AIH‐1 (21.9% vs 7%, P=.009). Personal history of CEHAID was more commonly found in AIH patients with than without first‐degree family history of CEHAID [48/86 (55.8%) vs 169/446 (37.9%), P=.002]. AIH patients with CEHAID were more often women (85.2% vs 76.1%, P=.008), had higher post‐treatment IAIHG score (22 vs 20, P<.001), less reactivity to smooth muscle antibodies (49.8% vs 65%, P<.001), more likely to have mild fibrosis at diagnosis (20.9% vs 6.5%, P<.001) and less often had ascites (6.3% vs 13.6%, P=.008) and coagulopathy (1.18 vs 1.27, P=.013) at presentation. Presence of CEHAID, however, did not significantly affect disease progression, prognosis and survival in AIH.
Conclusions
Our study confirms the strong association of CEHAID with AIH. Association between personal and familial extrahepatic autoimmunity especially among first‐degree relatives was evident. Presence of CEHAID may influence clinical phenotype of AIH at presentation, but without notable impact on the long‐term clinical outcomes.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antibodies</subject><subject>Ascites</subject><subject>Autoantibodies - blood</subject><subject>Autoimmune Diseases - classification</subject><subject>Autoimmune Diseases - epidemiology</subject><subject>autoimmune skin disease</subject><subject>autoimmune thyroiditis</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Databases, Factual</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Disease</subject><subject>Disease Progression</subject><subject>extrahepatic autoimmune diseases</subject><subject>Family Health</subject><subject>family history</subject><subject>Female</subject><subject>Fibrosis</subject><subject>first‐degree relatives</subject><subject>Genetics</subject><subject>Hepatitis</subject><subject>Hepatitis, Autoimmune - complications</subject><subject>Humans</subject><subject>Liver</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Skin diseases</subject><subject>Smooth muscle</subject><subject>Survival Analysis</subject><subject>Tertiary Care Centers</subject><subject>Thyroid</subject><subject>United Kingdom - epidemiology</subject><subject>Young Adult</subject><issn>1478-3223</issn><issn>1478-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp1kcuKFTEQhoMozkUXvoAE3MyAZ6Yrt07Pbjh4GTjgRt2GdLrOmKE7OSZp9ezEJ_AZfRKjPY4gWJuqn_r4qeIn5Ak0Z1DrfPSfzoAzru6RQxCtXtUZ7t_NjB-Qo5xvmga6TsJDcsBaKaBR_JB8W8fg5pQwFIpfSrIfcGeLd9TOJfppmoMve-rDX410QYrPF9RPu9G7qmLIdBsTHby9DjH7_Jy60Ye6G6mLc8pIbRjoGMP1j6_fC6aJxrm4OGF-RB5s7Zjx8W0_Ju9evni7fr3avHl1tb7crBzXWq06xXnrOoY9CD4o1gg3NABMtQqV3CrnNAhpe3C6FV2P4KRUTgCXqHpUmh-Tk8V3l-LHGXMxk88Ox9EGjHM2oGXXMs60qOizf9Cb-kOo1xnoWCOZlqKr1OlCuRRzTrg1u-Qnm_YGGvMrGFODMb-DqezTW8e5n3C4I_8kUYHzBfjsR9z_38lsrt4vlj8BvQaaWg</recordid><startdate>201703</startdate><enddate>201703</enddate><creator>Wong, Guan‐Wee</creator><creator>Yeong, Tian</creator><creator>Lawrence, David</creator><creator>Yeoman, Andrew D.</creator><creator>Verma, Sumita</creator><creator>Heneghan, Michael A.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>201703</creationdate><title>Concurrent extrahepatic autoimmunity in autoimmune hepatitis: implications for diagnosis, clinical course and long‐term outcomes</title><author>Wong, Guan‐Wee ; Yeong, Tian ; Lawrence, David ; Yeoman, Andrew D. ; Verma, Sumita ; Heneghan, Michael A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3886-96337c92eb143d6204cd0112676e65f6cc8145ab1c8749be1c556c4135e6be683</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antibodies</topic><topic>Ascites</topic><topic>Autoantibodies - blood</topic><topic>Autoimmune Diseases - classification</topic><topic>Autoimmune Diseases - epidemiology</topic><topic>autoimmune skin disease</topic><topic>autoimmune thyroiditis</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Databases, Factual</topic><topic>Diagnosis</topic><topic>Diagnostic systems</topic><topic>Disease</topic><topic>Disease Progression</topic><topic>extrahepatic autoimmune diseases</topic><topic>Family Health</topic><topic>family history</topic><topic>Female</topic><topic>Fibrosis</topic><topic>first‐degree relatives</topic><topic>Genetics</topic><topic>Hepatitis</topic><topic>Hepatitis, Autoimmune - complications</topic><topic>Humans</topic><topic>Liver</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Skin diseases</topic><topic>Smooth muscle</topic><topic>Survival Analysis</topic><topic>Tertiary Care Centers</topic><topic>Thyroid</topic><topic>United Kingdom - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wong, Guan‐Wee</creatorcontrib><creatorcontrib>Yeong, Tian</creatorcontrib><creatorcontrib>Lawrence, David</creatorcontrib><creatorcontrib>Yeoman, Andrew D.</creatorcontrib><creatorcontrib>Verma, Sumita</creatorcontrib><creatorcontrib>Heneghan, Michael A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Liver international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wong, Guan‐Wee</au><au>Yeong, Tian</au><au>Lawrence, David</au><au>Yeoman, Andrew D.</au><au>Verma, Sumita</au><au>Heneghan, Michael A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Concurrent extrahepatic autoimmunity in autoimmune hepatitis: implications for diagnosis, clinical course and long‐term outcomes</atitle><jtitle>Liver international</jtitle><addtitle>Liver Int</addtitle><date>2017-03</date><risdate>2017</risdate><volume>37</volume><issue>3</issue><spage>449</spage><epage>457</epage><pages>449-457</pages><issn>1478-3223</issn><eissn>1478-3231</eissn><abstract>Background
Concurrent extrahepatic autoimmune disease (CEHAID) associated with autoimmune hepatitis (AIH) have been incorporated into the diagnostic criteria stipulated by the International Autoimmune Hepatitis Group (IAIHG). Large comprehensive cohort data on the extrahepatic autoimmunity in AIH remain scanty.
Aim
To systematically assess features and clinical impact of CEHAID on AIH.
Methods
Clinical records of 562 patients with AIH from two tertiary centres in the UK were retrospectively reviewed.
Results
Prevalence of CEHAID in patients with AIH was 42%. Autoimmune thyroid disease was the commonest CEHAID associated with AIH (101/562, 18%). Autoimmune skin diseases were more prevalent in AIH‐2 than AIH‐1 (21.9% vs 7%, P=.009). Personal history of CEHAID was more commonly found in AIH patients with than without first‐degree family history of CEHAID [48/86 (55.8%) vs 169/446 (37.9%), P=.002]. AIH patients with CEHAID were more often women (85.2% vs 76.1%, P=.008), had higher post‐treatment IAIHG score (22 vs 20, P<.001), less reactivity to smooth muscle antibodies (49.8% vs 65%, P<.001), more likely to have mild fibrosis at diagnosis (20.9% vs 6.5%, P<.001) and less often had ascites (6.3% vs 13.6%, P=.008) and coagulopathy (1.18 vs 1.27, P=.013) at presentation. Presence of CEHAID, however, did not significantly affect disease progression, prognosis and survival in AIH.
Conclusions
Our study confirms the strong association of CEHAID with AIH. Association between personal and familial extrahepatic autoimmunity especially among first‐degree relatives was evident. Presence of CEHAID may influence clinical phenotype of AIH at presentation, but without notable impact on the long‐term clinical outcomes.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>27541063</pmid><doi>10.1111/liv.13236</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1478-3223 |
| ispartof | Liver international, 2017-03, Vol.37 (3), p.449-457 |
| issn | 1478-3223 1478-3231 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1859723284 |
| source | Wiley:Jisc Collections:Wiley Read and Publish Open Access 2024-2025 (reading list) |
| subjects | Adolescent Adult Aged Aged, 80 and over Antibodies Ascites Autoantibodies - blood Autoimmune Diseases - classification Autoimmune Diseases - epidemiology autoimmune skin disease autoimmune thyroiditis Child Child, Preschool Databases, Factual Diagnosis Diagnostic systems Disease Disease Progression extrahepatic autoimmune diseases Family Health family history Female Fibrosis first‐degree relatives Genetics Hepatitis Hepatitis, Autoimmune - complications Humans Liver Male Medical prognosis Middle Aged Patients Prognosis Retrospective Studies Risk Factors Skin diseases Smooth muscle Survival Analysis Tertiary Care Centers Thyroid United Kingdom - epidemiology Young Adult |
| title | Concurrent extrahepatic autoimmunity in autoimmune hepatitis: implications for diagnosis, clinical course and long‐term outcomes |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-31T23%3A44%3A49IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Concurrent%20extrahepatic%20autoimmunity%20in%20autoimmune%20hepatitis:%20implications%20for%20diagnosis,%20clinical%20course%20and%20long%E2%80%90term%20outcomes&rft.jtitle=Liver%20international&rft.au=Wong,%20Guan%E2%80%90Wee&rft.date=2017-03&rft.volume=37&rft.issue=3&rft.spage=449&rft.epage=457&rft.pages=449-457&rft.issn=1478-3223&rft.eissn=1478-3231&rft_id=info:doi/10.1111/liv.13236&rft_dat=%3Cproquest_cross%3E1920528549%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3886-96337c92eb143d6204cd0112676e65f6cc8145ab1c8749be1c556c4135e6be683%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1920528549&rft_id=info:pmid/27541063&rfr_iscdi=true |