Histological activity score on baseline liver biopsy can predict non-response to steroids in patients with severe alcoholic hepatitis

Baseline clinical and biochemical parameters fail to predict non-response to steroids in severe alcoholic hepatitis patients. Liver biopsy features have not been adequately assessed for predicting response to steroid therapy in severe alcoholic hepatitis. We aimed to identify histological parameters...

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Bibliographic Details
Published in:Virchows Archiv : an international journal of pathology 2018-04, Vol.472 (4), p.667-675
Main Authors: Shasthry, Saggere Muralikrishna, Rastogi, Archana, Bihari, Chhagan, Vijayaraghavan, Rajan, Arora, Vinod, Sharma, Manoj Kumar, Sarin, Shiv Kumar
Format: Article
Language:English
Subjects:
Balloon treatment
Biopsy
Corticoids
Corticosteroids
Data processing
Degeneration
Derivation
Hepatitis
Histology
Jaundice
Liver
Medicine
Medicine & Public Health
Original Article
Parameter identification
Parameters
Pathology
Patients
Steroid hormones
Steroids
Therapy
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Summary:Baseline clinical and biochemical parameters fail to predict non-response to steroids in severe alcoholic hepatitis patients. Liver biopsy features have not been adequately assessed for predicting response to steroid therapy in severe alcoholic hepatitis. We aimed to identify histological parameters, which can predict steroid response in severe alcoholic hepatitis (SAH). We analyzed histological data of 107 SAH patients (71 in a derivative and 36 in a validation cohort) who presented within 4 weeks after inset of jaundice and were prospectively treated with steroids (40 mg/day). Histopathological parameters were semi-quantitatively scored in the pre-therapy biopsies in the derivative cohort, and a histological scoring system of SAH was developed which differentiated between steroid responders (Lille score  5 for predicting steroid non-response was 0.731. Baseline histological parameters in SAH, ballooning degeneration, and Mallory-Denk bodies can reliably identify non-response to corticosteroids and help to stratify patients prior to introduction of therapy.
ISSN:0945-6317
1432-2307
DOI:10.1007/s00428-018-2330-4