Abstract
Autoimmune hepatitis (AIH) is an immune-mediated, necro-inflammatory liver disease that requires close life-long monitoring. In treated AIH, liver stiffness (LS) is an excellent noninvasive surrogate marker for fibrosis stages, even in those without complete biochemical remission. Hepatic inflammation adds to LS independent of the fibrosis stage and, consequently, decreases within the first weeks of immunosuppressive therapy. However, once patients have been treated for at least 6 months and AIH has stabilized without flares, inflammation usually has no further impact on LS. In conclusion, LS appears to be a valuable, noninvasive tool in monitoring patients with AIH, in particular to assure a lack of disease progression.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Krawitt EL. Autoimmune hepatitis. N Engl J Med. 2006;354(1):54–66.
Czaja AJ, Carpenter HA. Progressive fibrosis during corticosteroid therapy of autoimmune hepatitis. Hepatology. 2004;39(6):1631–8.
Dhaliwal HK, Hoeroldt BS, Dube AK, McFarlane E, Underwood JCE, Karajeh MA, et al. Long-term prognostic significance of persisting histological activity despite biochemical remission in autoimmune hepatitis. Am J Gastroenterol. 2015;110(7):993–9.
Grønbæk L, Vilstrup H, Jepsen P. Autoimmune hepatitis in Denmark: incidence, prevalence, prognosis, and causes of death. A nationwide registry-based cohort study. J Hepatol. 2014;60(3):612–7.
Goertz RS, GaBmann L, Strobel D, Wildner D, Schellhaas B, Neurath MF, et al. Acoustic Radiation Force Impulse (ARFI) elastography in autoimmune and cholestatic liver diseases. Ann Hepatol. 2019;18(1):23–9.
Guo L, Zheng L, Hu L, Zhou H, Yu L, Liang W. Transient elastography (FibroScan) performs better than non-invasive markers in assessing liver fibrosis and cirrhosis in autoimmune hepatitis patients. Med Sci Monit. 2017;23:5106–12.
Hartl J, Denzer U, Ehlken H, Zenouzi R, Peiseler M, Sebode M, et al. Transient elastography in autoimmune hepatitis: timing determines the impact of inflammation and fibrosis. J Hepatol. 2016;65(4):769–75.
Hartl J, Ehlken H, Sebode M, Peiseler M, Krech T, Zenouzi R, et al. Usefulness of biochemical remission and transient elastography in monitoring disease course in autoimmune hepatitis. J Hepatol. 2018;68(4):754–63.
Park DW, Lee YJ, Chang W, Park JH, Lee KH, Kim YH, et al. Diagnostic performance of a point shear wave elastography (pSWE) for hepatic fibrosis in patients with autoimmune liver disease. PLoS One. 2019;14(3):e0212771.
Sun LL, Dong G, Wang B, Zheng Q, Wang S, Zhang RF. Real-time shear wave elastrography and APRI index for evaluating autoimmune hepatitis fibrosis. J Biol Regul Homeost Agents. 2016;30(4):1019–21.
Xu Q, Sheng L, Bao H, Chen X, Guo C, Li H, et al. Evaluation of transient elastography in assessing liver fibrosis in patients with autoimmune hepatitis. J Gastroenterol Hepatol. 2017;32(3):639–44.
Bota S, Herkner H, Sporea I, Salzl P, Sirli R, Neghina AM, et al. Meta-analysis: ARFI elastography versus transient elastography for the evaluation of liver fibrosis. Liver Int. 2013;33(8):1138–47.
Poynard T, Pham T, Perazzo H, Munteanu M, Luckina E, Elaribi D, et al. Real-time shear wave versus transient elastography for predicting fibrosis: applicability, and impact of inflammation and steatosis. A non-invasive comparison. PLoS One. 2016;11(10):e0163276.
EASL-ALEH clinical practice guidelines: non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol. 2015;63(1):237–64.
Coco B, Oliveri F, Maina AM, Ciccorossi P, Sacco R, Colombatto P, et al. Transient elastography: a new surrogate marker of liver fibrosis influenced by major changes of transaminases. J Viral Hepat. 2007;14(5):360–9.
Tapper EB, Cohen EB, Patel K, Bacon B, Gordon S, Lawitz E, et al. Levels of alanine aminotransferase confound use of transient elastography to diagnose fibrosis in patients with chronic hepatitis C virus infection. Clin Gastroenterol Hepatol. 2012;10(8):932–7.e1.
Mueller S, Millonig G, Sarovska L, Friedrich S, Reimann FM, Pritsch M, et al. Increased liver stiffness in alcoholic liver disease: differentiating fibrosis from steatohepatitis. World J Gastroenterol. 2010;16(8):966–72.
Soloway RD, Summerskill WHJ, Baggenstoss AH, Geall MG, Gitnick GL, Elveback LR, et al. Clinical, biochemical, and histological remission of severe chronic active liver disease: a controlled study of treatments and early prognosis. Gastroenterology. 1972;63(5):820–33.
Mueller S, Englert S, Seitz HK, Badea RI, Erhardt A, Bozaari B, et al. Inflammation-adapted liver stiffness values for improved fibrosis staging in patients with hepatitis C virus and alcoholic liver disease. Liver Int. 2015;35(12):2514–21.
Lüth S, Herkel J, Kanzler S, Frenzel C, Galle PR, Dienes HP, et al. Serologic markers compared with liver biopsy for monitoring disease activity in autoimmune hepatitis. J Clin Gastroenterol. 2008;42(8):926–30.
Corrigendum to “EASL Clinical Practice Guidelines: Autoimmune hepatitis” [J Hepatol 2015;63:971–1004]. J Hepatol. 2015;63(6):1543–4.
Mueller J, Rausch V, Silva I, Peccerella T, Piecha F, Dietrich C, et al. PS-171-Survival in a 10 year prospective cohort of heavy drinkers: liver stiffness is the best long-term prognostic parameter. J Hepatol. 2019;70(1):E107-E.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Hartl, J. (2020). Liver Stiffness in Autoimmune Hepatitis. In: Mueller, S. (eds) Liver Elastography. Springer, Cham. https://doi.org/10.1007/978-3-030-40542-7_16
Download citation
DOI: https://doi.org/10.1007/978-3-030-40542-7_16
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-40541-0
Online ISBN: 978-3-030-40542-7
eBook Packages: MedicineMedicine (R0)