کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
3282531 | 1209150 | 2014 | 33 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Cholestatic Phenotypes of Autoimmune Hepatitis
ترجمه فارسی عنوان
فنوتیپ های کلستاتیک هپاتیت اتوایمیون
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کلمات کلیدی
ERCEASLULNPBCAIHGGTMRCALTPSCγ-Glutamyl transferase - γ-گلوتامیل ترانسفرازAlanine aminotransferase - آلانین آمینوترانسفرازAlkaline phosphatase - آلکالین فسفاتاز یا فسفاتاز قلیاییantimitochondrial Antibody - آنتی بادی antimitohondrialAMA - اماEuropean Association for the Study of the Liver - انجمن اروپایی برای مطالعه کبدUpper limit of normal - حد بالای طبیعیPrimary biliary cirrhosis - سیروز صفراوی اولیهoverlap - همپوشانیAutoimmune hepatitis - هپاتیت اتوایمیونPrimary sclerosing cholangitis - کلانژیت اسکلروئیدی اولیهcholestasis - کلستاز
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
بیماریهای گوارشی
چکیده انگلیسی
Autoimmune hepatitis can have cholestatic features that are outside the codified diagnostic criteria. These features have uncertain effects on the clinical presentation and progression of disease. Patients with autoimmune hepatitis can have antimitochondrial antibodies and coincidental bile duct injury or loss (2%-13% of patients), focal biliary strictures and dilations based on cholangiography (2%-11%), or histologic changes of bile duct injury or loss in the absence of other features (5%-11%). These findings probably represent atypical manifestations of autoimmune hepatitis or variants of primary biliary cirrhosis or primary sclerosing cholangitis, depending on the predominant findings. Serum levels of alkaline phosphatase and γ-glutamyl transferase, histologic features of bile duct injury, and findings from cholangiography are associated with responsiveness to corticosteroid therapy and individualized alternative treatments. Corticosteroid therapy, in combination with low-dose ursodeoxycholic acid, has been promulgated by international societies, but these recommendations are not based on strong evidence. The frequency, variable outcomes, and uncertainties in diagnosis and management of the cholestatic phenotypes must be addressed by a collaborative investigational network. This network should define the genetic and pathologic features of these disorders, standardize their nomenclature, and establish a treatment algorithm. In this review, the different cholestatic phenotypes of autoimmune hepatitis, mechanisms of pathogenesis, current management strategies and outcomes, and opportunities for improving understanding and therapy are presented.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Clinical Gastroenterology and Hepatology - Volume 12, Issue 9, September 2014, Pages 1430-1438
Journal: Clinical Gastroenterology and Hepatology - Volume 12, Issue 9, September 2014, Pages 1430-1438
نویسندگان
Albert J. Czaja,