title: Type I autoimmune hepatitis: clinical course and outcome in an Italian multicentre study.
abstract: BACKGROUND
  Many reports of autoimmune hepatitis (AIH) were written in the 'pre-Hepatitis C era' and data on the natural history are still incomplete.
  
  
  OBJECTIVE
  To evaluate the clinical presentation and the natural history of type I AIH.
  
  
  METHODS
  Seventy-three consecutive patients with a regular follow-up of at least 2 years were prospectively included in the study. The mean follow-up was 91 +/- 61 months.
  
  
  RESULTS
  Patients with 'acute' onset at presentation were significantly older than patients with 'chronic' onset (P < 0.05) and had significantly higher serum levels of transaminase, gamma-glutamyltransferase and bilirubin; Prothrombin time was significantly lower in the said group compared with AIH patients with 'chronic' onset. In 4 of 63 (6.3%) female patients, AIH had the onset during pregnancy; in all of them the outcome of pregnancy was favourable. The major events during the follow-up included oesophageal varices (n = 9) and ascites (n = 4), and 60 patients remained in remission while receiving immunosuppression. None of the patients died during the follow-up, but seven patients were transplanted. The cumulative transplant-free probability of survival was 73.5% at 280 months.
  
  
  CONCLUSIONS
  Elderly patients have more frequently an acute onset at presentation. Survival in AIH is apparently good; with early diagnosis, and improved medical therapy, liver transplantation for AIH will become a rare event in future.
authors.affiliation: Department of Surgical and Gastroenterological Sciences, University of Padova, Padova, Italy. annarosa.floreani@unipd.it
authors.forename: A
authors.initials: A
authors.lastname: Floreani
authors.forename: G
authors.initials: G
authors.lastname: Niro
authors.forename: E
authors.initials: E
authors.lastname: Rosa Rizzotto
authors.forename: S
authors.initials: S
authors.lastname: Antoniazzi
authors.forename: F
authors.initials: F
authors.lastname: Ferrara
authors.forename: I
authors.initials: I
authors.lastname: Carderi
authors.forename: V
authors.initials: V
authors.lastname: Baldo
authors.forename: A
authors.initials: A
authors.lastname: Premoli
authors.forename: F
authors.initials: F
authors.lastname: Olivero
authors.forename: E
authors.initials: E
authors.lastname: Morello
authors.forename: M
authors.initials: M
authors.lastname: Durazzo
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D005260:Female; D019693:Hepatitis, Autoimmune / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers