CLINICAL AND PROGNOSTIC IMPLICATIONS OF HLA B8 IN CORTICOSTEROID-TREATED SEVERE AUTOIMMUNE CHRONIC ACTIVE HEPATITIS

被引:56
作者
CZAJA, AJ
RAKELA, J
HAY, JE
MOORE, SB
机构
[1] MAYO CLIN & MAYO FDN,DIV LAB MED,ROCHESTER,MN 55905
[2] MAYO CLIN & MAYO GRAD SCH MED,ROCHESTER,MN 55901
关键词
D O I
10.1016/0016-5085(90)91095-N
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
To assess the clinical and prognostic implications of human leukocyte antigen B8 in corticosteroid-treated severe autoimmune chronic active hepatitis, 81 consecutive patients were tested for histocompatibility antigens on the A and B loci, treated with corticosteroids, and followed prospectively for 111 ± 8 mo. The 47 patients with HLA-B8 were younger (38 ± 2 yr vs. 48 ± 2 yr; p < 0.01), had higher serum levels of aspartate aminotransferase (658 ± 60 U/L vs. 465 ± 49 U/L; p = 0.02) and bilirubin (7 ± 1 mg/dl vs. 2.8 ± 0.4 mg/dl; p = 0.003), and more commonly had histologic features of bridging necrosis, multilobular necrosis, and cirrhosis (85% vs. 56%; p < 0.01) at presentation than the 34 patients without HLA-B8. Remission (79% vs. 71%), relapse after drug withdrawal (76% vs. 71%), treatment failure (13% vs. 6%), progression to cirrhosis (46% vs. 32%), and death from liver failure (6% vs. 3%) occurred as frequently in patients with and without HLA-B8. Importantly, HLA-B8-negative patients with HLA-A1 relapsed less frequently than HLA-B8-positive patients with and without HLA-A1- and HLA-B8-negative counterparts without HLA-A1. It is concluded that HLA-B8-positive patients are younger and have more severe disease at presentation than HLA-B8-negative patients. The HLA-B8 phenotype does not influence the response to corticosteroid therapy. HLA-B8-negative patients with HLA-A1 relapse less frequently than other phenotypes. © 1990.
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页码:1587 / 1593
页数:7
相关论文
共 40 条
[1]   HL-A SYSTEM AND DIABETES-MELLITUS [J].
CUDWORTH, AG ;
WOODROW, JC .
DIABETES, 1975, 24 (04) :345-349
[2]  
CZAJA AJ, 1984, SEMIN LIVER DIS, V4, P1, DOI 10.1055/s-2008-1040641
[3]   FEATURES REFLECTIVE OF EARLY PROGNOSIS IN CORTICOSTEROID-TREATED SEVERE AUTOIMMUNE CHRONIC ACTIVE HEPATITIS [J].
CZAJA, AJ ;
RAKELA, J ;
LUDWIG, J .
GASTROENTEROLOGY, 1988, 95 (02) :448-453
[4]   COMPLETE RESOLUTION OF INFLAMMATORY ACTIVITY FOLLOWING CORTICOSTEROID TREATMENT OF HBSAG-NEGATIVE CHRONIC ACTIVE HEPATITIS [J].
CZAJA, AJ ;
DAVIS, GL ;
LUDWIG, J ;
TASWELL, HF .
HEPATOLOGY, 1984, 4 (04) :622-627
[5]  
CZAJA AJ, 1983, GASTROENTEROLOGY, V85, P713
[6]  
DEGROOTE J, 1968, LANCET, V2, P626
[7]  
Eddleston A L, 1979, Prog Liver Dis, V6, P285
[8]  
EDDLESTON ALWF, 1985, Q J MED, V55, P191
[9]   GENETICALLY DETERMINED IMMUNE HYPERREACTIVITY IN HUMAN LIVER-DISEASE [J].
EDDLESTON, ALWF .
PROCEEDINGS OF THE ROYAL SOCIETY OF MEDICINE-LONDON, 1977, 70 (08) :525-529
[10]  
EDDLESTON ALWF, 1978, BRIT MED BULL, V34, P295, DOI 10.1093/oxfordjournals.bmb.a071515