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Alcohol consumption in patients with primary sclerosing cholangitis.

https://arctichealth.org/en/permalink/ahliterature122648
Source
World J Gastroenterol. 2012 Jun 28;18(24):3105-11
Publication Type
Article
Date
Jun-28-2012
Author
Hannes Hagström
Per Stål
Knut Stokkeland
Annika Bergquist
Author Affiliation
Department of Gastroenterology and Hepatology, Karolinska University Hospital, Karolinska Institutet, 14186 Stockholm, Sweden. hannes.hagstrom@ki.se
Source
World J Gastroenterol. 2012 Jun 28;18(24):3105-11
Date
Jun-28-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Alcohol drinking - epidemiology
Analysis of Variance
Binge Drinking - epidemiology
Chi-Square Distribution
Cholangitis, Sclerosing - diagnosis - epidemiology
Disease Progression
Elasticity Imaging Techniques
Female
Humans
Liver Cirrhosis, Alcoholic - diagnosis - epidemiology
Male
Middle Aged
Predictive value of tests
Questionnaires
Registries
Retrospective Studies
Risk assessment
Risk factors
Sweden - epidemiology
Time Factors
Young Adult
Abstract
To assess the alcohol drinking patterns in a cohort of primary sclerosing cholangitis (PSC) patients and the possible influence on the development of fibrosis.
Ninety-six patients with PSC were evaluated with a validated questionnaire about a patient's lifetime drinking habits: the lifetime drinking history (LDH) questionnaire. In addition, clinical status, transient elastography and biochemistry values were analysed and registered. Patients were defined as having either significant or non-significant fibrosis. Significant fibrosis was defined as either an elastography value of = 17.3 kPa or the presence of clinical signs of cirrhosis. Patients were divided into two groups depending on their alcohol consumption patterns; no/low alcohol consumption (one drink or unit/d) and moderate/high alcohol consumption (= 1 drink or unit/d). LDH data were calculated to estimate lifetime alcohol intake (LAI), current alcohol intake, drinks per year before and after diagnosis of PSC. We also calculated the number of episodes of binge-drinking (defined as consuming = 5 drinks per occasion) in total, before and after the diagnosis of PSC.
The mean LAI was 3882 units of alcohol, giving a mean intake after onset of alcohol consumption of 2.6 units per week. Only 9% of patients consumed alcohol equal to or more than one unit per day. Current alcohol intake in patients with significant fibrosis (n = 26) was less than in patients without significant fibrosis (n = 70), as shown by lower values of phosphatidylethanol (B-PEth) (0.1 ?mol/L vs 0.33 ?mol/L, respectively, P = 0.002) and carbohydrate-deficient transferrin (CDT) (0.88% vs 1.06%, respectively, P = 0.02). Self-reported LAI was similar between the two groups. Patients with significant fibrosis reduced their alcohol intake after diagnosis from 103 to 88 units per year whereas patients without fibrosis increased their alcohol intake after PSC diagnosis from 111 to 151 units/year. There were no correlations between elastography values and intake of alcohol (units/year) (r = -0.036).
PSC patients have low alcohol consumption. The lack of correlation between fibrosis and alcohol intake indicates that a low alcohol intake is safe in these patients.
Notes
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PubMed ID
22791946 View in PubMed
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Characteristics and long-term outcome of patients with autoimmune hepatitis related to the initial treatment response.

https://arctichealth.org/en/permalink/ahliterature98330
Source
Scand J Gastroenterol. 2010 Apr;45(4):457-67
Publication Type
Article
Date
Apr-2010
Author
Mårten Werner
Sven Wallerstedt
Stefan Lindgren
Sven Almer
Einar Björnsson
Annika Bergquist
Hanne Prytz
Hanna Sandberg-Gertzén
Rolf Hultcrantz
Per Sangfelt
Ola Weiland
Bodil Ohlsson
Ake Danielsson
Author Affiliation
Department of Medicine, Sections for Hepatology and Gastroenterology, Umeå University Hospital, Umeå, Sweden. marten.werner@vll.se
Source
Scand J Gastroenterol. 2010 Apr;45(4):457-67
Date
Apr-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Cause of Death
Chi-Square Distribution
Child
Child, Preschool
Disease Progression
Female
Hepatitis, Autoimmune - diagnosis - epidemiology - therapy
Humans
Liver Function Tests
Liver Transplantation - statistics & numerical data
Male
Middle Aged
Prognosis
Proportional Hazards Models
Registries
Risk factors
Survival Rate
Sweden
Treatment Outcome
Abstract
OBJECTIVES: Autoimmune hepatitis (AIH) is a liver disease which, if untreated, may lead to liver cirrhosis and hepatic failure. Limited data exist regarding factors predicting the long-term outcome. The aims of this study were to investigate symptoms at presentation, prognostic features, management and treatment in relation to long-term outcome of AIH. MATERIAL AND METHODS: A cohort of 473 Swedish patients with AIH was characterized regarding initial symptoms and signs, factors predicting death and future need for liver transplantation. Survival and causes of death were retrieved from Swedish national registers. RESULTS: At diagnosis, fatigue was a predominant symptom (69%), 47% of the patients were jaundiced and 30% had liver cirrhosis. Another 10% developed cirrhosis during follow-up. Markedly elevated alanine aminotransferase levels at presentation were correlated with a better outcome. A high international normalized ratio (INR) at diagnosis was the only risk factor predicting a need for later liver transplantation. Histological cirrhosis, decompensation and non-response to initial treatment were all factors that correlated with a worse outcome. Overall life expectancy was generally favourable. However, most deaths were liver-related, e.g. liver failure, shock and gastrointestinal bleeding. CONCLUSIONS: Cirrhosis at diagnosis, a non-response to initial immune-suppressive treatment or elevated INR values were associated with worse outcome and a need for later liver transplantation. In contrast, an acute hepatitis-like onset with intact synthetic capacity indicated a good response to treatment and favourable long-term prognosis. Lifetime maintenance therapy is most often required.
PubMed ID
20082594 View in PubMed
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Epidemiology and causes of death in a Swedish cohort of patients with autoimmune hepatitis.

https://arctichealth.org/en/permalink/ahliterature291617
Source
Scand J Gastroenterol. 2017 Sep; 52(9):1022-1028
Publication Type
Journal Article
Date
Sep-2017
Author
Åsa Danielsson Borssén
Hanns-Ulrich Marschall
Annika Bergquist
Fredrik Rorsman
Ola Weiland
Stergios Kechagias
Nils Nyhlin
Hans Verbaan
Emma Nilsson
Mårten Werner
Author Affiliation
a Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden.
Source
Scand J Gastroenterol. 2017 Sep; 52(9):1022-1028
Date
Sep-2017
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Cause of Death
Child
Child, Preschool
Female
Hepatitis, Autoimmune - complications - mortality
Humans
Incidence
Infant
Infant, Newborn
Liver Cirrhosis - mortality - surgery
Liver Transplantation
Male
Middle Aged
Prevalence
Registries
Retrospective Studies
Risk factors
Sex Distribution
Survival Analysis
Sweden - epidemiology
Young Adult
Abstract
Epidemiological studies of autoimmune hepatitis (AIH) show varying figures on prevalence and incidence, and data on the long-term prognosis are scarce. Objective To investigate the epidemiology, long-term prognosis and causes of death in a Swedish AIH cohort.
Data collected from 634 AIH patients were matched to the Cause of Death Registry, and survival analyses were made. Prevalence and incidence were calculated for university hospitals with full coverage of cases and compared to the County of Västerbotten in Northern Sweden.
AIH point prevalence was 17.3/100,000 inhabitants in 2009, and the yearly incidence 1990-2009 was 1.2/100,000 inhabitants and year. The time between diagnosis and end of follow-up, liver transplantation or death was in median 11.3 years (range 0-51.5 years). Men were diagnosed earlier (p?
PubMed ID
28562110 View in PubMed
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Hepatocellular and extrahepatic cancer in patients with autoimmune hepatitis--a long-term follow-up study in 634 Swedish patients.

https://arctichealth.org/en/permalink/ahliterature266296
Source
Scand J Gastroenterol. 2015 Feb;50(2):217-23
Publication Type
Article
Date
Feb-2015
Author
Åsa Danielsson Borssén
Sven Almer
Hanne Prytz
Sven Wallerstedt
Inga-Lill Friis-Liby
Annika Bergquist
Nils Nyhlin
Rolf Hultcrantz
Per Sangfelt
Ola Weiland
Stefan Lindgren
Hans Verbaan
Mårten Werner
Source
Scand J Gastroenterol. 2015 Feb;50(2):217-23
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Carcinoma, Hepatocellular - epidemiology
Cohort Studies
Female
Follow-Up Studies
Hepatitis, Autoimmune - epidemiology
Humans
Incidence
Liver Cirrhosis - epidemiology
Liver Neoplasms - epidemiology
Male
Middle Aged
Registries
Risk factors
Skin Neoplasms - epidemiology
Sweden - epidemiology
Abstract
Cirrhosis is a well-known risk factor for hepatocellular cancer, but the true risk in autoimmune hepatitis (AIH) is scarcely studied. Other cancers may arise after prolonged use of immune-modulating drugs. The aim of this study was to investigate the cancer risk in a large cohort of AIH patients.
Six hundred and thirty-four Swedish patients in a well-defined cohort were matched to the Cause of Death Registry and the Cancer Registry. Standard incidence ratios were calculated by relating the incidences in the cohort to an age-matched material from the Swedish background population.
A higher overall incidence of malignancies than the background population was found, counting from the date of diagnosis (standard incidence ratio (SIR) 2.08, 95% CI 1.68-2.55). The highest risk was found for hepatocellular carcinoma (HCC). We found 10 cases (4.0%) in 248 patients with cirrhosis, which gives an incidence rate of 0.3%. Standard incidence ratio for developing hepatobiliary cancer was 54.55 (95% CI 19.92-99.99). HCC only occurred in cirrhotic patients. There was also an increased risk for non-melanoma skin cancer (SIR 9.87, 95% CI 6.26-14.81).
A slightly enhanced risk for malignancies in general compared to the background population was found. The risk of hepatobiliary cancer was increased, but the annual risk over the observational period was well under the postulated 1.5% when surveillance in cirrhotic patients is considered to be cost-effective.
PubMed ID
25483724 View in PubMed
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