RT Journal Article
T1 Noninvasive Prediction of Outcomes in Autoimmune Hepatitis-Related Cirrhosis.
A1 Llovet, Laura-Patricia
A1 Gratacos-Gines, Jordi
A1 Tellez, Luis
A1 Gomez-Outomuro, Ana
A1 Navascues, Carmen A
A1 Riveiro-Barciela, Mar
A1 Vinuesa, Raquel
A1 Gomez-Camarero, Judith
A1 Garcia-Retortillo, Montserrat
A1 Diaz-Fontenla, Fernando
A1 Salcedo, Magdalena
A1 Garcia-Eliz, Maria
A1 Horta, Diana
A1 Guerrero, Marta
A1 Rodriguez-Peralvarez, Manuel
A1 Fernandez-Rodriguez, Conrado
A1 Albillos, Agustin
A1 G-Abraldes, Juan
A1 Pares, Albert
A1 Londoño, Maria-Carlota
K1 Elasticity imaging techniques
K1 Esophageal and gastric varices
K1 Female
K1 Hepatitis, autoimmune
AB The value of noninvasive tools in the diagnosis of autoimmune hepatitis (AIH)-related cirrhosis and the prediction of clinical outcomes is largely unknown. We sought to evaluate (1) the utility of liver stiffness measurement (LSM) in the diagnosis of cirrhosis and (2) the performance of the Sixth Baveno Consensus on Portal Hypertension (Baveno VI), expanded Baveno VI, and the ANTICIPATE models in predicting the absence of varices needing treatment (VNT). A multicenter cohort of 132 patients with AIH-related cirrhosis was retrospectively analyzed. LSM and endoscopies performed at the time of cirrhosis diagnosis were recorded. Most of the patients were female (66%), with a median age of 54 years. Only 33%-49% of patients had a LSM above the cutoff points described for the diagnosis of AIH-related cirrhosis (12.5, 14, and 16 kPa). Patients with portal hypertension (PHT) had significantly higher LSM than those without PHT (15.7 vs. 11.7 kPa; P = 0.001), but 39%-52% of patients with PHT still had LSM below these limits. The time since AIH diagnosis negatively correlated with LSM, with longer time being significantly associated with a lower proportion of patients with LSM above these cutoffs. VNT was present in 12 endoscopies. The use of the Baveno VI, expanded Baveno VI criteria, and the ANTICIPATE model would have saved 46%-63% of endoscopies, but the latter underpredicted the risk of VNT. Conclusions: LSM cutoff points do not have a good discriminative capacity for the diagnosis of AIH-related cirrhosis, especially long-term after treatment initiation. Noninvasive tools are helpful to triage patients for endoscopy.
PB Wolters Kluwer Health
YR 2021
FD 2021-12-06
LK http://hdl.handle.net/10668/21962
UL http://hdl.handle.net/10668/21962
LA en
NO Llovet LP, Gratacós-Ginès J, Téllez L, Gómez-Outomuro A, Navascués CA, Riveiro-Barciela M, et al. Noninvasive Prediction of Outcomes in Autoimmune Hepatitis-Related Cirrhosis. Hepatol Commun. 2022 Jun;6(6):1392-1402
DS RISalud
RD Apr 19, 2025