scholarly journals Brazilian society of hepatology recommendations for the diagnosis and management of autoimmune diseases of the liver

2015 ◽  
Vol 52 (suppl 1) ◽  
pp. 15-46 ◽  
Author(s):  
Paulo Lisboa Bittencourt ◽  
Eduardo Luiz Rachid Cançado ◽  
Cláudia Alves Couto ◽  
Cynthia Levy ◽  
Gilda Porta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Biliary Cirrhosis ◽  
Autoimmune Diseases ◽  
Sclerosing Cholangitis ◽  
Evidence Based ◽  
Biliary Cirrhosis ◽  
Review Of The Literature ◽  
Final Version ◽  
Overlap Syndromes ◽  
Brazilian Society

ABSTRACT In order to draw evidence-based recommendations concerning the management of autoimmune diseases of the liver, the Brazilian Society of Hepatology has sponsored a single-topic meeting in October 18th, 2014 at São Paulo. An organizing committee comprised of seven investigators was previously elected by the Governing Board to organize the scientific agenda as well as to select twenty panelists to make a systematic review of the literature and to present topics related to the diagnosis and treatment of autoimmune hepatitis, primary sclerosing cholangitis, primary biliary cirrhosis and their overlap syndromes. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of those recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present paper is the final version of the reviewed manuscript organized in topics, followed by the recommendations of the Brazilian Society of Hepatology.

scholarly journals Overlap syndromes in hepatic autoimmune diseases

2017 ◽  
Vol 95 (10) ◽  
pp. 940-945
Author(s):  
V. I. Podzolkov ◽  
Natal’ya A. Dragomiretskaya ◽  
E. V. Volchkova ◽  
O. I. Mitrokhina
Keyword(s):  
Primary Biliary Cirrhosis ◽  
Autoimmune Diseases ◽  
Autoimmune Hepatitis ◽  
Primary Sclerosing Cholangitis ◽  
Clinical Picture ◽  
Sclerosing Cholangitis ◽  
Biliary Cirrhosis ◽  
Overlap Syndromes

Autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC) comprise a group of autoimmune hepatic disorders. Sometimes, overlap syndromes occur, e.g. AIH/PBC or AIH/PSC. The authors consider autoimmune hepatic disorders with reference to pathogenesis, clinical picture, diagnostics, and treatment of overlap syndromes.

scholarly journals Brazilian society of hepatology recommendations for the diagnosis and treatment of hepatocellular carcinoma

2015 ◽  
Vol 52 (suppl 1) ◽  
pp. 2-14 ◽  
Author(s):  
Flair J Carrilho ◽  
Angelo Alves de Mattos ◽  
Alex F Vianey ◽  
Denise Cerqueira P Vezozzo ◽  
Fábio Marinho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
High Rate ◽  
Diagnosis And Treatment ◽  
Evidence Based ◽  
Review Of The Literature ◽  
Final Version ◽  
Brazilian Society ◽  
Staging Systems ◽  
Development Methods

ABSTRACT Hepatocellular carcinoma is a malignancy of global importance and is associated with a high rate of mortality. Recent advances in the diagnosis and treatment of this disease make it imperative to update the recommendations on the management of the disease. In order to draw evidence-based recommendations concering the diagnosis and management of hepatocellular carcinoma, the Brazilian Society of Hepatology has sponsored a single-topic meeting in João Pessoa (PB). All the invited pannelists were asked to make a systematic review of the literature and to present topics related to the risk factors for its development, methods of screening, radiological diagnosis, staging systems, curative and palliative treatments and hepatocellular carcinoma in noncirrhotic liver. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of those recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present paper is the final version of the reviewed manuscript containing the recommendations of the Brazilian Society of Hepatology.

scholarly journals UPDATE OF THE BRAZILIAN SOCIETY OF HEPATOLOGY RECOMMENDATIONS FOR DIAGNOSIS AND MANAGEMENT OF AUTOIMMUNE DISEASES OF THE LIVER

2019 ◽  
Vol 56 (2) ◽  
pp. 232-241 ◽  
Author(s):  
Cláudia Alves COUTO ◽  
Debora Raquel Benedita TERRABUIO ◽  
Eduardo Luiz Rachid CANÇADO ◽  
Gilda PORTA ◽  
Cynthia LEVY ◽  
...  
Keyword(s):  
Autoimmune Diseases ◽  
Autoimmune Hepatitis ◽  
Primary Sclerosing Cholangitis ◽  
Liver Diseases ◽  
Sclerosing Cholangitis ◽  
Primary Biliary Cholangitis ◽  
Web Based ◽  
Overlap Syndromes ◽  
Brazilian Society ◽  
Consensus Document

ABSTRACT New data concerning the management of autoimmune liver diseases have emerged since the last single-topic meeting sponsored by the Brazilian Society of Hepatology to draw recommendations about the diagnosis and treatment of autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), overlap syndromes of AIH, PBC and PSC and specific complications and topics concerning AIH and cholestatic liver diseases. This manuscript updates those previous recommendations according to the best evidence available in the literature up to now. The same panel of experts that took part in the first consensus document reviewed all recommendations, which were subsequently scrutinized by all members of the Brazilian Society of Hepatology using a web-based approach. The new recommendations are presented herein.

scholarly journals Diagnosis and Management of the Overlap Syndromes of Autoimmune Hepatitis

2013 ◽  
Vol 27 (7) ◽  
pp. 417-423 ◽  
Author(s):  
Albert J Czaja
Keyword(s):  
Primary Biliary Cirrhosis ◽  
Autoimmune Hepatitis ◽  
Ursodeoxycholic Acid ◽  
Immunosuppressive Therapy ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Overlap Syndrome ◽  
Biliary Cirrhosis ◽  
Diagnostic Features ◽  
Overlap Syndromes

BACKGROUND: Autoimmune hepatitis may have cholestatic features that are outside the classical phenotype and that resemble findings in other immune-mediated liver diseases. These cholestatic phenotypes have been designated ‘overlap syndromes’.OBJECTIVES: To recognize the overlap syndromes in adults and manage them appropriately.METHODS: The MEDLINE database was reviewed for published experiences from 1984 to 2013.RESULTS: Patients with autoimmune hepatitis may exhibit features of primary biliary cirrhosis (7% to 13%), primary sclerosing cholangitis (6% to 11%) or a cholestatic syndrome without other diagnostic features (5% to 11%). These mixed phenotypes may represent classical autoimmune hepatitis with atypical features, transition states in the evolution of classical cholestatic syndromes, concurrent separate diseases or pathogenically distinct disorders. The ‘Paris criteria’ have been endorsed for the diagnosis of the overlap syndrome with primary biliary cirrhosis, and treatment with conventional immunosuppressive therapy alone or in combination with low-dose ursodeoxycholic acid can be guided by the serum alkaline phosphatase level. The overlap syndrome with primary sclerosing cholangitis or with cholestasis without diagnostic features is commonly treated with immunosuppressive therapy and ursodeoxycholic acid. Responses are variable and commonly incomplete (20% to 100% improvement) depending on the degree of cholestasis.DISCUSSION: The overlap syndromes are clinical descriptions rather than pathological entities, and the dominant component of the disease determines its designation and therapy. Cholestatic findings in autoimmune hepatitis influence the response to immunosuppressive therapy.CONCLUSION: The overlap syndromes must be considered in patients with autoimmune hepatitis and cholestatic findings, concurrent inflammatory bowel disease or steroid-refractory disease.

scholarly journals BRAZILIAN SOCIETY OF HEPATOLOGY UPDATED RECOMMENDATIONS FOR DIAGNOSIS AND TREATMENT OF HEPATOCELLULAR CARCINOMA

2020 ◽  
Vol 57 (suppl 1) ◽  
pp. 1-20 ◽  
Author(s):  
Aline Lopes CHAGAS ◽  
Angelo Alves de MATTOS ◽  
Flair José CARRILHO ◽  
Paulo Lisboa BITTENCOURT ◽  
Denise Cerqueira Paranaguá VEZOZZO ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Sao Paulo ◽  
Diagnosis And Treatment ◽  
Governing Board ◽  
São Paulo ◽  
Review Of The Literature ◽  
Final Version ◽  
Brazilian Society ◽  
Related Mortality

ABSTRACT Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. The Brazilian Society of Hepatology (SBH) published in 2015 its first recommendations about the management of HCC. Since then, new data have emerged in the literature, prompting the governing board of SBH to sponsor a single-topic meeting in August 2018 in São Paulo. All the invited experts were asked to make a systematic review of the literature reviewing the management of HCC in subjects with cirrhosis. After the meeting, all panelists gathered together for the discussion of the topics and the elaboration of updated recommendations. The text was subsequently submitted for suggestions and approval of all members of the Brazilian Society of Hepatology through its homepage. The present manuscript is the final version of the reviewed manuscript containing the recommendations of SBH.

scholarly journals Review of overlap syndromes of autoimmune liver diseases. Difficulties in the diagnosis and treatment

2013 ◽  
Vol 154 (24) ◽  
pp. 923-929 ◽  
Author(s):  
Krisztina Hagymási ◽  
Zsolt Tulassay
Keyword(s):  
Primary Biliary Cirrhosis ◽  
Liver Diseases ◽  
Sclerosing Cholangitis ◽  
Clinical Signs ◽  
Corticosteroid Treatment ◽  
Overlap Syndrome ◽  
Biliary Cirrhosis ◽  
Histological Findings ◽  
Overlap Syndromes ◽  
Autoimmune Liver Diseases

Overlap syndromes are biochemical, serological, histological and radiological overlaps across the classic autoimmune liver diseases in the presence of autoimmun hepatitis and primary biliary cirrhosis or primary sclerosing cholangitis. The exact prevalence of the disease is not known, but it may vary between 5% and 20%. Because it has no generally accepted diagnostic criteria, clinical signs, biochemical, serological, radiological and histological findings are evaluated together. Treatment depends on the predominant feature of the overlap syndrome; ursodeoxycholic acid and/or immunsuppressive (corticosteroid) treatment are used, based on observations from retrospective, non-randomized studies. Orv. Hetil., 2013, 154, 923–929.

scholarly journals AUTOIMMUNE CHOLESTATIC LESIONS OF BILIARY DUCTS

2021 ◽  
Vol 5 (2) ◽  
pp. 99-110
Author(s):  
V. M. Tsyrkunov ◽  
◽  
N. I. Prokopchik ◽  
V. P. Andreev ◽  
◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Primary Biliary Cirrhosis ◽  
Sclerosing Cholangitis ◽  
Bile Ducts ◽  
Light And Electron Microscopy ◽  
Biliary Cirrhosis ◽  
Immunoglobulin G4 ◽  
Overlap Syndromes ◽  
Autoimmune Sclerosing Cholangitis ◽  
Biliary Ducts

The review presents literature data and original findings of light and electron microscopy of pathomorphological changes in the bile ducts in primary sclerosing cholangitis (PSC), immunoglobulin G4 (IgG4)-associated autoimmune sclerosing cholangitis and overlap syndromes: PSC + chronic autoimmune hepatitis (AIH); PSC + primary biliary cirrhosis (PBC).

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