提高肝功能和正常肝组织学自然过程

StephenW

Natural course of subjects with elevated liver tests and normal liver histology

    Michael Strasser1, Andreas Stadlmayr2, Heike Haufe3, Felix Stickel4, Peter Ferenci5, Wolfgang Patsch6, Alexandra Feldman1,7, Daniel Weghuber7,8, Christian Datz2,7 andElmar Aigner1,7,*

Article first published online: 6 SEP 2015

DOI: 10.1111/liv.12935

© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Issue
Liver International
Liver International

Volume 36, Issue 1, pages 119–125, January 2016



    1    First Department of Medicine, Paracelsus Medical University, Salzburg, Austria
    2    Department of Internal Medicine, Oberndorf Hospital, Oberndorf, Austria
    3    Department of Pathology, Paracelsus Medical University, Salzburg, Austria
    4    Hepatology Unit, Clinic Beau-Site, Bern and Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
    5    Third Department of Medicine, Gastroenterology and Hepatology, Medical University Vienna, Vienna, Austria
    6    Department of Pharmacology and Toxicology, Paracelsus Medical University, Salzburg, Austria
    7    Obesity Research Unit, Paracelsus Medical Univrsity, Salzburg, Austria
    8    Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria

* Correspondence
Elmar Aigner, MD, First Department of Medicine, Paracelsus Medical University, Müllner Hauptstrasse 48, Salzburg A-5020, Austria
Tel: +43 662 4482 58358
Fax: +43 662 4482 51034
e-mail: [email protected]

    Handling Editor: Francesco Negro

   
Abstract
Background & Aims

Liver biopsy (LB) is performed if non-invasive work-up of liver disease is inconclusive. The examination of liver tissue occasionally reveals normal histology. Long-term follow-up of such patients has not been performed.
Methods

We identified a total 70 subjects from our LB database with elevated liver tests and normal liver histology after a mean of 90.5 ± 52.3 (range 15–216) months and conducted reassessment of medical history, physical examination, laboratory testing, ultrasound, transient elastography and LB if indicated.
Results

At follow-up examination, 15 (7 females (f)/8 males (m); 21.4%) subjects had normal liver tests and no further evidence of liver disease. A subset of 37 (29 f/8 m; 52.9%) subjects had persistently elevated liver tests without evidence indicating progressive liver disease but the cause thereof remained unexplained also at the follow-up visit. Three (0 f/3 m; 4.3%) subjects had consumed excessive alcohol with indicators of alcoholic liver disease. Eleven subjects (4 f/7 m; 15.7%) had developed steatosis on ultrasound examination along with weight gain and/or biochemical features of the metabolic syndrome. In addition, three (2 f/1 m) patients developed autoimmune hepatitis, one female presented with primary biliary cirrhosis. One male was diagnosed with cholangiocellular carcinoma 3 months after the initial evaluation.
Conclusion

The clinical course of most patients was benign, but in approximately 20% of the subjects a liver disease developed. Particular attention should be given to autoimmune liver diseases in subjects with positive autoantibodies. In addition, lifestyle factors such as weight gain and alcohol consumption were associated with the manifestation of liver diseases.

StephenW

主题自然过程与提高肝功能和正常肝组织学

    迈克尔Strasser1，安德烈亚斯Stadlmayr2，海克Haufe3，菲利克斯Stickel4，彼得Ferenci5，沃尔夫冈Patsch6，亚历山德拉Feldman1,7，丹尼尔Weghuber7,8，基督教Datz2,7 andElmar Aigner1,7，*

文章首次在网上公布：2015年9月6日

DOI：10.1111 / liv.12935

©2015年约翰·威利父子A / S。由John Wiley＆Sons出版有限公司

问题
肝国际
肝国际

第36卷，第1期，页119-125，2016年一月



    医药，帕拉塞尔苏斯医科大学，萨尔茨堡，奥地利1一科
    内科，奥本多夫医院，奥本多夫，奥地利2部
    病理学，帕拉塞尔苏斯医科大学，萨尔茨堡，奥地利3系
    4肝病单位，诊所博站点，伯尔尼和消化内科和肝病，苏黎世大学医院，苏黎世，瑞士
    内科，消化和肝病，医科大学，维也纳，奥地利5三科
    药理学和毒理学，帕拉塞尔苏斯医科大学，萨尔茨堡，奥地利6系
    7肥胖研究单位，帕拉塞尔苏斯医学论高校，萨尔茨堡，奥地利
    儿科，帕拉塞尔苏斯医科大学，萨尔茨堡，奥地利8部

* 对应
艾玛·爱格纳，医学博士，医学一科，帕拉塞尔苏斯医科大学MüllnerHAUPTSTRASSE 48，萨尔茨堡A-5020，奥地利
联系电话：+43 662 4482 58358
传真：+43 662 4482 51034
电子邮件：[email protected]

    处理编辑：弗朗西斯黑人

   
抽象
背景和目的

肝活检（LB）是，如果非侵入性的工作了肝病尚无定论执行。肝组织的检查偶尔揭示正常的组织学。尚未执行长期随访此类患者。
方法

我们确定了共70科，从我们与肝酶升高测试和正常肝组织学LB数据库，平均90.5±52.3（范围15-216）个月后进行的病史，体格检查，实验室检查，超声检查，瞬时弹性成像和重新评估LB如果表示。
结果

在随访检查，15（7位女性（F）/ 8男性（米）; 21.4％）受试者具有正常肝功能和肝疾病的没有进一步的证据。 37的子集（29 f / 8光圈米; 52.9％）患者有持续升高的肝测试，没有证据表明进展性肝病，但其原因仍然不明原因也在随访。三（0 F / 3米; 4.3％）患者曾饮用过量酒精与酒精性肝病的指标。 11名受试者（4 F / 7米; 15.7％）已经制定脂肪变性的超声检查与体重增加和/或代谢综合征的生化功能。此外，三（2的f / 1米）患者发展自身免疫性肝炎，1雌性呈现原发性胆汁性肝硬化。一名男性被诊断出初评3个月后胆管细胞癌。
结论

大多数患者的临床过程是良性的，但在受试者约20％肝脏疾病的发展。应特别注意的科目与自身抗体阳性考虑自身免疫性肝病。此外，生活方式因素如体重增加和酒精消费均与肝疾病的表现。