scholarly journals Autoimmune hepatitis: Clinical characteristics and predictors of biochemical response to treatment

2020 ◽  
Vol 8 (2) ◽  
pp. 106-111
Author(s):  
Abbas Ali Tasneem ◽  
Nasir Hassan Luck
Keyword(s):  
Liver Disease ◽  
Autoimmune Hepatitis ◽  
Clinical Characteristics ◽  
Total Bilirubin ◽  
Post Treatment ◽  
Response To Treatment ◽  
Biochemical Response ◽  
Serum Total Bilirubin ◽  
Serum Igg ◽  
Pre Treatment

AbstractBackground and ObjectivesAutoimmune hepatitis (AIH) is an important cause of chronic liver disease. Aim of this study was to evaluate the clinical characteristics and factors predicting response to treatment in patients with AIH.MethodsIn this prospective observational study, all patients diagnosed with AIH from 2017 to 2019 were included. Biochemical response to the treatment was checked three months after the start of the treatment. Response was considered good if transaminases normalized, or poor if either remained persistently elevated or improved partially.ResultsOf the total 56 patients, 41 (73.2%) were females. Mean age was 29.5 (±16.9) years. About half (53.6%; n = 30) the patients were aged < 25 years and majority [47 (83.9%)] were cirrhotic. Autoimmune serology was negative in 20 (35.7%). Seronegativity was associated with severe necroinflammation (P = 0.015) and esophageal varices (P = 0.021). Response to treatment was good in 34 (60.7%). Bivariate analysis showed that good response to treatment was associated with pre-treatment serum IgG level > 20 g/L (P = 0.024), presence of pseudorosettes on histopathology (P = 0.029) and three months post-immunosuppression serum total bilirubin < 2mg/dL (P < 0.001). Multivariate logistic regression analysis showed that only pre-treatment serum IgG >20 g/L (P = 0.038) and post-treatment serum total bilirubin <2 mg/dL (P = 0.004) were independent predictors of good response to treatment.ConclusionMajority of AIH patients in our study were young and cirrhotic. A negative autoimmune serology does not rule out AIH and liver biopsy may be required to confirm the diagnosis. Seronegative AIH rapidly progresses to advanced liver disease. Response to treatment is good with pre-treatment IgG > 20g/L and post-treatment total bilirubin < 2 mg/dL.

Worse Response to Ursodeoxycholic Acid in Primary Biliary Cholangitis Patients with Autoimmune Hepatitis Features

2020 ◽  
Author(s):  
Maoyao Wen ◽  
Ruoting Men ◽  
Xiaoli Fan ◽  
Yi Shen ◽  
Ping Ni ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Ursodeoxycholic Acid ◽  
Total Bilirubin ◽  
Response Rate ◽  
Immunosuppressive Agents ◽  
Biochemical Response ◽  
Primary Biliary Cholangitis ◽  
Lower Response Rate ◽  
One Year ◽  
Glutamyl Transpeptidase

Background: There is limited evidence on the treatment response of primary biliary cholangitis (PBC) with autoimmune hepatitis (AIH) features but not meet the criteria of PBC-AIH syndromes. This study was to elucidate the clinical characteristics of PBC patients with features of AIH. Methods: We included patients with diagnostic criteria of PBC. All patients were treated with ursodeoxycholic acid (UDCA) and without immunosuppressive agents for more than one year. The biochemical response was evaluated at one year after treatment of UCDA. Results: Among 432 patients with PBC, 166 (38.4%) patients did not achieve biochemical response within one year of UDCA treatment. Non-responders had lower albumin (ALB) level and higher immunoglobulin G (IgG), alanine transaminase (ALT), alanine aminotransferase (AST), alkaline phosphatase (ALP), glutamyl transpeptidase (GGT) and total bilirubin (TB) levels (P < 0.05). The response rates were significantly lower in patients with elevated level of IgG or ALT or AST. Moreover, the higher the IgG or AST level was, the lower the response rate was in patients with PBC regardless of cirrhosis. For patients with cirrhosis, there was no differences among patients with different level of ALT. Patients in the PBC with AIH features group had a significant lower response rate than patients in the PBC-only group. Among the 139 patients who underwent liver biopsy, 54 were non-responsive to UDCA and 48 (88.9%) shown mild interface hepatitis. Conclusion: In conclusion, PBC patients with AIH features had a worse response to UDCA therapy.

Total bilirubin as a predictive marker for irinotecan-induced toxicity in patients with gastrointestinal cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 68-68
Author(s):  
Katsuya Makihara ◽  
Sayaka Azuma ◽  
Hiroko Hasegawa ◽  
Masataka Ikeda ◽  
Kazumasa Fujitani ◽  
...  
Keyword(s):  
Gastrointestinal Cancer ◽  
Total Bilirubin ◽  
Total Bilirubin Level ◽  
Predictive Marker ◽  
Severe Neutropenia ◽  
Serum Total Bilirubin ◽  
Characteristic Analysis ◽  
Pre Treatment ◽  
Grade 3 ◽  
Experienced Grade

68 Background: Irinotecan (CPT-11) is widely used for the treatment of patients with gastrointestinal cancer. However, CPT-11 can cause severe neutropenia and diarrhea.It has been reported that the AUC of SN-38, an active metabolite of CPT-11, correlated with Pre-treatment serum total bilirubin level (PTB), but there is no criteria of dose setting based on the PTB. Therefore, we retrospectively searched the PTB which can serve as an indicator for dose setting of CPT-11. Methods: We investigated the incidence of neutropenia and diarrhea at the first 28 days in patients with gastrointestinal cancer who were administered CPT-11 alone in Osaka National Hospital from June 2006 to July 2013. Correlation between PTB and grade 3-4 neutropenia or diarrhea were assessed. When toxicity of correlation exists, ROC (receiver operating characteristic) analysis was conducted to explore the cut-off value of the PTB. In addition, the incidence of febrile neutropenia (FN) in the cut-off value was compared. Results: 87 patients were analyzed. Of these, 65 were gastric cancer, 22 were colorectal cancer. Although PTB was significantly higher in patients who experienced grade 3-4 neutropenia than those who didn’t (p<0.001), PTB was not associated with grade 3-4 diarrhea. As the results of ROC analysis, cut-off value of PTB associated with grade 3-4 neutropenia was determined to 0.8 mg/dL. The incidence of FN was significantly higher in 20% of patients with PTB ≥ 0.8 mg/dL compared with 1.6% of patients with PTB < 0.8 mg/dL (OR: 15.5, p=0.01). On the other hand, in subgroup analysis showed no difference in the incidence of FN and neutropenia in patients whose dose was less than 100 mg/m². Conclusions: PTB was a predictive marker for CPT-11-induced severe neutropenia and FN. Results of this study suggested needs of dose reduction to less than 100 mg/m2 in patients with PTB ≥ 0.8mg/dL.

Pre-treatment serum total bilirubin level as an indicator of optimal CPT-11 dosage

2014 ◽  
Vol 75 (2) ◽  
pp. 273-279 ◽  
Author(s):  
Katsuya Makihara ◽  
Sayaka Azuma ◽  
Nobuyuki Kawato ◽  
Hiroyuki Ueno ◽  
Izumi Nakata
Keyword(s):  
Bilirubin Level ◽  
Total Bilirubin ◽  
Total Bilirubin Level ◽  
Serum Total Bilirubin ◽  
Pre Treatment

scholarly journals A retrospective study of the clinical characteristics and post-treatment hearing outcome in idiopathic sudden sensorineural hearing loss

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Purushothaman Ganesan ◽  
Purushothaman Pavanjur Kothandaraman ◽  
Simham Swapna ◽  
Vinaya Manchaiah
Keyword(s):  
Hearing Loss ◽  
Retrospective Study ◽  
Sensorineural Hearing Loss ◽  
Recovery Rate ◽  
Clinical Characteristics ◽  
Sudden Sensorineural Hearing Loss ◽  
Post Treatment ◽  
Sensorineural Hearing ◽  
Hearing Recovery ◽  
Pre Treatment

The purpose of this retrospective study was to analyze the clinical characteristics and document hearing recovery in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). 122 patients diagnosed with unilateral ISSNHL, from March 2009 to December 2014, were treated with oral steroids and pentoxifylline. Hearing change was evaluated by comparing pre-treatment and post-treatment pure-tone average (PTA) (500, 1K, and 2K Hz), and categorized into complete, partial, and no recovery of hearing. T-test, Wilcoxon Signed Rank test and Regression analysis were employed to analyze the statistical significance. Of the 122 patients, seventy-one (58%) had complete recovery and 34 (28%) had partial recovery. The average pre-treatment PTA was 78.3 ± 16.9 dB whereas post-treatment average was 47.0 ± 20.8 dB, showing statistically significant improvement (t=24.89, P≤0.001). The factors such as presence of tinnitus (P=0.005) and initial milder hearing loss (P=0.005) were found to be significant predictors for hearing recovery. Conventional steroid regimes produced a recovery rate in ISSNHL, which exceeds the spontaneous recovery rate. The current study results highlight the importance of medical treatment in the management of ISSNHL.

scholarly journals Role of squamous cell carcinoma antigen in monitoring of treatment response of cervical and vaginal malignancies

2017 ◽  
Vol 03 (01) ◽  
pp. 066-070
Author(s):  
Rekha Sachan ◽  
Munna Patel ◽  
Meenakshi Singh ◽  
Pushpalata Sachan ◽  
Radhey Shyam
Keyword(s):  
Cervical Cancer ◽  
Stage Iv ◽  
Post Treatment ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Response To Treatment ◽  
Developed Country ◽  
Vaginal Carcinoma ◽  
Pre Treatment

Abstract Introduction: As per GLOBOCAN 2012 report Worldwide fourth most common cancer in the female is cervical cancer and approximately 528,000 new cases was found in 2012 in large majority of global burden was found in less developed country. India, the second most populous country in the world, accounts for 27% of the total cervical cancer deaths. The aim of this study was to assess the efficacy of squamous cells carcinoma antigen (SCC-Ag) in monitoring of response to treatment in cervical and vaginal cancer patients. Materials and Methods: This prospective case–control study was carried out over a period of 1 year in the Department of Obstetrics and Gynecology in collaboration with the Department of Internal Medicine and Pathology. Histopathologically confirmed study group included 8 cases of Stage I, 15 cases of Stage II, 15 cases of Stage III, 8 cases of Stage IV cervical malignancy, and 5 cases of vaginal carcinoma. About 15 healthy cervical cytology-negative women were taken as controls. Results: Out of 51 cancer cases SCC-Ag level were determined in only Stage I, II, III, and IV cases, assess the response to treatment. The mean SCC-Ag level in all four stage groups decreased significantly after post treatment as compared to pre treatment (P < 0.001) and the decrease in post treatment SCC-Ag level increased linearly with stage severity. Similarly, comparing the total or overall (Stage I + Stage II + Stage III) mean change (pre-post) in SCC-Ag level, t-test further revealed significant (P < 0.001) and decrease of 66.2% at posttreatment as compared to pretreatment. Conclusion: SCC-Ag might be a useful marker in monitoring the response to treatment.

scholarly journals Autoimmune Hepatitis as a Unique Form of an Autoimmune Liver Disease: Immunological Aspects and Clinical Overview

2012 ◽  
Vol 2012 ◽  
pp. 1-17 ◽  
Author(s):  
Hind I. Fallatah ◽  
Hisham O. Akbar
Keyword(s):  
Liver Disease ◽  
Autoimmune Hepatitis ◽  
Response To Treatment ◽  
Unique Form ◽  
Decompensated Liver Cirrhosis ◽  
Aggressive Disease ◽  
Immune Mediated ◽  
Acute Liver Disease ◽  
Progressive Liver Disease ◽  
Clinical Overview

Autoimmune hepatitis (AIH) is a unique form of immune-mediated disease that attacks the liver through a variety of immune mechanisms. The outcomes of AIH are either acute liver disease, which can be fatal, or, more commonly, chronic progressive liver disease, which can lead to decompensated liver cirrhosis if left untreated. AIH has characteristic immunological, and pathological, features that are important for the establishment of the diagnosis. More importantly, most patients with AIH have a favorable response to treatment with prednisolone and azathioprine, although some patients with refractory AIH or more aggressive disease require more potent immune-suppressant agents, such as cyclosporine or Mycophenolate Mofetil. In this paper, we discuss the immunological, pathological and clinical features of AIH, as well as the standard and alternative treatments for AIH.

scholarly journals Role of PET/CT in initial evaluation of lymphoma patients

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Manar Mohamed Naguib ◽  
Samer Malak Botros ◽  
Amir Louis Louka ◽  
Rasha S. Hussein
Keyword(s):  
Prognostic Value ◽  
Post Treatment ◽  
Response To Treatment ◽  
Patient Response ◽  
Quantitative Pet ◽  
Pet Ct ◽  
Pre Treatment ◽  
Patient Prognosis ◽  
Treatment Prognosis

Abstract Background Accurate radiologic assessment of treatment response in lymphoma patients is important to evaluate the effectiveness of treatment and consequently predict the relapse; the value of PET/CT for post-treatment prognosis prediction has been recently investigated. The aim of this study is to highlight the prognostic value of PET-CT metabolic volumetric parameters in the evaluation of lymphoma patients. Results Among the included 40 patients, post-treatment SUV, MTV, and TLG were significantly lower in a responsive group than the non-responsive group. % changes of all quantitative PET/CT parameters were significantly higher in the responsive group than the non-responsive group. Conclusions This study suggests that pre-treatment PET/CT quantitative measures (except baseline SUVmax) are not conclusive in the prediction of patient response to treatment; however, the ΔSUVmax, ΔMTV, and ΔTLG% from the baseline to the end of therapy could be used in predicting patient response to treatment, determining patient prognosis, and suggesting the relapse.

scholarly journals Comparison of botulinum toxin with surgery for the treatment of acute acquired comitant esotropia and its clinical characteristics

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Li-juan Lang ◽  
Yu Zhu ◽  
Zhi-gang Li ◽  
Guang-ying Zheng ◽  
Hai-ying Peng ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Success Rate ◽  
Clinical Characteristics ◽  
Botulinum Toxin Injection ◽  
Post Treatment ◽  
Therapeutic Effects ◽  
Deviation Angle ◽  
Before And After ◽  
Pre Treatment ◽  
Group B

Abstract We compared the therapeutic effects between botulinum toxin and surgery for acute acquired comitant esotropia (AACE) and analyze its clinical characteristics. The data of the 29 cases, who received treatment for AACE in the Ophthalmic Center of the First Affiliated Hospital of Zhengzhou University and Henan Provincial Ophthalmology Hospital between January 2016 and January 2017, were collected. The 29 cases with AACE were followed for 6 months or more, and received either botulinum toxin injection (group A with 13 cases) or squint correction (group B with 16 cases). The distant and near deviation angles were compared between the two groups before and after treatment. The success rate (total horizontal deviation of 10 prism diopters or less) and stereopsis were compared between the two groups at post-treatment 6 months. At the same time, the relations between distant and near deviation angles were analyzed among different myopia levels and different AACE types. Results indicated that he success rate was not significantly different at post-treatment 6 months (84.6% vs 81.3%, P = 1.00). The distant and near deviation angles were all significantly different one day and one month after treatment (all P < 0.05); but at post-treatment 6 months, they were not significantly different (all P > 0.05) between the two groups. There were no significant differences in the distant and near stereoacuity between the two groups at post-treatment 6 months (all P > 0.05). Among the 25 cases with myopia, the pre-treatment distant deviation angle was significantly higher than pre-treatment near deviation angle in the cases with myopia level >−2.5 D (P < 0.05), and the pre-treatment distant and near deviation angles were all significantly higher in the cases with type-IIAACE than in the cases with type-IIIAACE (all P < 0.05). This study suggests that Botulinum toxin is as effective as surgery in the treatment of AACE at post-treatment 6 months. For the cases with myopia level >−2.5 D, the pre-treatment distant deviation angle is significantly higher than pre-treatment near deviation angle; and both pre-treatment distant and near deviation angles are greater in the cases with type-IIAACE than in the cases with type-IIIAACE.

The Schizophrenic as Soothsayer

1976 ◽  
Vol 39 (2) ◽  
pp. 635-642
Author(s):  
Arthur L. Sterne ◽  
Paul J. Martin ◽  
Joseph E. Moore ◽  
Ruth M. McNairy
Keyword(s):  
Hospital Admission ◽  
Therapeutic Response ◽  
Post Treatment ◽  
Response To Treatment ◽  
Objective Measures ◽  
Short Term ◽  
Outcome Relationship ◽  
Schizophrenic Patients ◽  
Pre Treatment

It is generally believed that patients' prognostic expectancies are linked to the outcome of treatment. It is also generally believed that the nature of the expectancy-outcome relationship is causative: patients' expectancies are viewed as causing or facilirating patients' responses to treatment. The study reported here tested both notions. The expectancies of hospitalized schizophrenic patients were tested by multiple regression for association with objective measures of the patients' pre- and post-treatment adjustment. Expectancy measures were closely correlated with patients' pre-treatment adjustment at hospital admission, were moderately correlated with patients' post-treatment adjustment at discharge, and were almost completely independent of post-treatment adjustment at 9-mo. follow-up. It is speculated that patients may base their prognostic expectancies partly on their pre-treatment adjustment, that patients' expectancies are associated with short-term measures of outcome, and that patients' expectancies predict but do not primarily cause or facilitate a therapeutic response to treatment for hospitalized schizophrenic patients. Finally, limitations of the findings and their generalizability are discussed.

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