Reversibility of hepatic fibrosis in autoimmune hepatitis.
BACKGROUND
Hepatic fibrosis and cirrhosis occur in many types of chronic liver injury and generally seem to be irreversible.


OBJECTIVE
To determine whether cirrhosis caused by autoimmune hepatitis can be reversible.


METHODS
Retrospective study.


METHODS
Eight patients with autoimmune hepatitis and cirrhosis who responded to medical therapy and had follow-up liver biopsy while in clinical and biochemical remission.


METHODS
Biopsy specimens were randomly coded in an unpaired manner according to patient and were read independently by two pathologists using the Knodell scoring system.


RESULTS
The median alanine aminotransferase level decreased from 10.30 mukat/L to 0.37 mukat/L, the median serum bilirubin level decreased from 70 mumol/L to 10 mumol/L, and the median serum albumin level increased from 34 g/L to 43 g/L. Cirrhosis, extensive fibrosis, or both were present in all patients at diagnosis but were not present on follow-up liver biopsy. The median Knodell score decreased from 14.0 to 1.3, and the median fibrosis score decreased from 3.3 to 0.8.


CONCLUSIONS
Hepatic fibrosis and cirrhosis may be reversible in some patients in whom autoimmune hepatitis responds to treatment.
Dufour
J F
JF
Department of Pathology, New England Medical Center, Boston, MA 02111, USA.
DeLellis
R
R
Kaplan
M M
MM
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D019693:Hepatitis, Autoimmune / Q000150:complications* / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies
D005938:Glucocorticoids; D007166:Immunosuppressive Agents