АУТОИММУННЫЙ ГЕПАТИТ: МОРФОЛОГИЧЕСКИЕ АСПЕКТЫ
Аннотация
В обзоре представлены литературные данные, касающиеся основных патоморфологических особенностей аутоиммунного гепатита (АИГ) и результаты световой и электронной микроскопии в виде фотографий и описания разных вариантов морфологических изменений в печени у пациентов с АИГ. Предложены дополнения в разделы классификации АИГ, касающиеся этиологии и происхождения АИГ, приведены клинические примеры с описанием особенностей морфологии по уточненной авторами классификации.Литература
Waldenstrom J. The diagnostic importance of ACTH. J. Acta Endocrinol. 1950;5(3):235-242. https://doi.org/10.1530/acta.0.0050235.
Kunkel HG, Ahrens EH, Eisenmenger WJ, Bongiovanni AM, Slater RJ. Extreme hypergammaglobulinemia in young women with liver disease of unknown etiology. J. Clin. Invest. 1951;30:654.
Johnson PJ, McFarlane I.G. Meeting report: International Autoimmune Hepatitis Group. Hepatology. 1993;18(4):998-1005. https://doi.org/10.1002/hep.1840180435.
Floreani A, Restrepo-Jiménez P, Secchi MF, De Martin S, Leung PSC, Krawitt E, Bowlus CL, Gershwin ME, Anaya J-M. Etiopathogenesis of autoimmune hepatitis. J. Autoimmun. 2018;95:133-143. https://doi.org/10.1016/j.jaut.2018.10.020.
Autoimmunnyj gepatit [Internet]. Available from: http://doctor-365.net/autoimmunnyj-gepatit/ (Russian).
Sucher E, Sucher R, Gradistanac T, Brandacher G, Schneeberger S, Berg T. Autoimmune HepatitisImmunologically Triggered Liver Pathogenesis-Diagnostic and Therapeutic. J. Immunol Res. 2019;2019:9437043. https://doi.org/10.1155/2019/9437043.
Manns MP, Lohse AW, Vergani D. Autoimmune hepatitis-Update 2015. J. Hepatol. 2015;62(1 Suppl):S100-111. https://doi.org/10.1016/j.jhep.2015.03.005.
Patogenez autoimmunnogo gepatita [Internet]. Available from: https://studopedia.ru/13_27301_vopros-patogenez-autoimmunnogo-gepatita.html (Russian).
Heneghan MA, Yeoman AD, Verma S, Smith AD, Longhi MS. Autoimmune hepatitis. Lancet. 2013;382(9902):1433-1444. https://doi.org/10.1016/S0140-6736(12)62163-1.
Czaja AJ. Diagnosis and management of autoimmune hepatitis: current status and future directions. Gut Liver. 2016;10(2):177-203. https://doi.org/10.5009/gnl15352.
European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Autoimmune hepatitis. J. Hepatol. 2015;63(4):971-1004. https://doi.org/10.1016/j.jhep.2015.06.030.
Ortega-Alonso A, Andrade RJ. Chronic liver injury induced by drugs and toxins. J. Dig. Dis. 2018;19(9):514-521. https://doi.org/10.1111/1751-2980.12612.
Malevich K. Autoimmunnyj gepatit (klinika, diagnostika, lechenie) [Internet]. Makhachkala; 2013. Available from: https://pandia.ru/text/80/332/84652.php (Russian).
Manns M, Gerken G, Kyriatsoulis A, Staritz M, Meyer zum Büschenfelde KH. Characterization of a new subgroup of autoimmune chronic active hepatitis by autoantibodies against a soluble liver antigen. Lancet. 1987;1(8528):292-294. https://doi.org/10.1016/s0140-6736(87)92024-1.
Kanzler S, Weidemann C, Gerken G, Löhr HF, Galle PR, Meyer zum Büschenfelde KH, Lohse AW. Clinical significance of autoantibodies to soluble liver antigen in autoimmune hepatitis. J. Hepatol. 1999;31(4):635-640. https://doi.org/10.1016/s0168-8278(99)80342-0.
Czaja AJ, Donaldson PT, Lohse AW. Antibodies to soluble liver antigen/liver pancreas and HLA risk factors for type 1 autoimmune hepatitis. Am. J. Gastroenterol. 2002;97(2):413-419. https://doi.org/10.1111/j.1572-0241.2002.05479.x.
Lohse AW, Mieli-Vergani G. Autoimmune hepatitis. J. Hepatol. 2011;55(1):171-182. https://doi.org/10.1016/j.jhep.2010.12.012.
Autoimmunnyj gepatit. Rasprostranennost, prichiny, diagnostika i lechenie, prognoz [Internet]. Available from: http://kingmed.info/articles/Obshchaya_vrachebnaya_praktika/Gastroenterologiya/article_69/Autoimmunniy_gepatit (Russian).
Szabó Z. The role of liver biopsy in the diagnosis of autoimmune hepatitis. Orv. Hetil. 2006;147(35):1697-1702.
Aizawa Y, Abe H, Sugita T, Seki N, Chuganji Y, Furumoto Y, Sakata A. Centrilobular zonal necrosis as a hallmark of a distinctive subtype of autoimmune hepatitis. Eur. J. Gastroenterol. Hepatol. 2016;28(4):391-397. https://doi.org/10.1097/MEG.0000000000000545.
Zen Y, Notsumata K, Tanaka N, Nakanuma Y. Hepatic centrilobular zonal necrosis with positive antinuclear antibody: a unique subtype or early disease of autoimmune hepatitis? Hum. Pathol. 2007;38(11):1669-1675. https://doi.org/10.1016/j.humpath.2007.03.019.
Hofer H, Oesterreicher C, Wrba F, Ferenci P, Penner E. Centrilobular necrosis in autoimmune hepatitis: a histological feature associated with acute clinical presentation. J. Clin. Pathol. 2006;59(3):246-249. https://doi.org/10.1136/jcp.2005.029348.
Duclos-Vallée J-C, Ichai P, Samuel D. Autoimmune acute liver failure. Hepatology. 2011;54(1):372-373. https://doi.org/10.1002/hep.24337.
Stravitz RT, Lefkowitch JH, Fontana RJ, Gershwin ME, Leung PSC, Sterling RK, Manns MP, Norman GL, Lee WM; Acute Liver Failure Study Group. Autoimmune acute liver failure: proposed clinical and histological criteria. Hepatology. 2011;53(2):517-526. https://doi.org/10.1002/hep.24080.
Lotowska JM, Sobaniec-Lotowska ME, Daniluk U, Lebensztejn DM. Glassy droplet inclusions within the cytoplasm of Kupffer cells: A novel ultrastructural feature for the diagnosis of pediatric autoimmune hepatitis. Dig. Liver Dis. 2017;49(8):929-933. https://doi.org/10.1016/j.dld.2017.04.001.
Tucker SM, Jonas MM, Perez-Atayde AR. Hyaline droplets in Kupffer cells: a novel diagnostic clue for autoimmune hepatitis. Am. J. Surg. Pathol. 2015;39(6):772-778. https://doi.org/10.1097/PAS.0000000000000395.
Himoto T, Kadota K, Fujita K, Nomura T, Morishita A, Yoneyama H, Masaki T. The pathological appearance of hyaline droplets in Kupffer cells is not specific to patients with autoimmune hepatitis. Int. J. Clin. Exp. Pathol. 2017;10(8):8703-8708.
Łotowska JM, Sobaniec-Łotowska ME, Sobaniec P, Lebensztejn DM. Liver sinusoidal endothelial cells in morphogenesis of pediatric autoimmune hepatitis. Ultrastructural characteristics – a novel report. Pol. J. Pathol. 2018;69(4):327-334. https://doi.org/10.5114/pjp.2018.81691.
Bach N, Thung SN, Schaffner F. The histological features of chronic hepatitis C and autoimmune chronic hepatitis: a comparative analysis. Hepatology. 1992;15(4):572-577. https://doi.org/10.1002/hep.1840150403.
Autoimmunnyj gepatit: obzor gistologicheskih osobennostej, vkljuchennyh v uproshhennye kriterii, predlozhennye Mezhdunarodnoj gruppoj autoimmunnogo gepatita, i predlozhenie Novyh gistologicheskih kriteriev [Internet]. Available from: https://rus.kyhistotechs.com/autoimmunehepatitis-review-histologic-features-included-simplifiedcriteria-proposed-international-autoimmune-75677567 (Russian).
Portnov A. Autoimmunnyj gepatit: prichiny i patogenez [Internet]. Available from: https://ilive.com.ua/health/autoimmunnyy-gepatit-prichiny-i-patogenez_85540i15947.html (Russian).
Hennes EM, Zeniya M, Czaja AJ, Parés A, Dalekos GN, Krawitt EL, Bittencourt PL, Porta G, Boberg KM, Hofer H, Bianchi FB, Shibata M, Schramm C, Eisenmann de Torres B, Galle PR, McFarlane I, Dienes HP, Lohse AW; International Autoimmune Hepatitis Group. Simplified criteria for the diagnosis of autoimmune hepatitis. Hepatology. 2008;48(1):169-176. https://doi.org/10.1002/hep.22322.
Desmet VJ, Gerber M, Hoofnagle JH, Manns M, Scheuer PJ. Classification of chronic hepatitis: diagnosis, grading and staging. Hepatology. 1994;19(6):1513-1520.
Kessler WR, Cummings OW, Eckert G, Chalasani N, Lumeng L, Kwo PY. Fulminant hepatic failure as the initial presentation of acute autoimmune hepatitis. Clin. Gastroenterol. Hepatol. 2004;2(7):625-631. https://doi.org/10.1016/s1542-3565(04)00246-0.
Burgart LJ, Batts KP, Ludwig J, Nikias GA, Czaja AJ. Recent-onset autoimmune hepatitis. Biopsy findings and clinical correlations. Am. J. Surg. Pathol. 1995;19(6):699-708. https://doi.org/10.1097/00000478-199506000-00010.
Manns MP, Czaja AJ, Gorham JD, Krawitt EL, Mieli-Vergani G, Vergani D, Vierling JM; American Association for the Study of Liver Diseases. Diagnosis and management of autoimmune hepatitis. Hepatology. 2010;51(6):2193-2213. https://doi.org/10.1002/hep.23584.
Gleeson D, Heneghan MA; British Society of Gastroenterology. British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis. Gut. 2011;60(12):1611-1629. https://doi.org/10.1136/gut.2010.235259.
Gutkowski K, Hartleb M, Kacperek-Hartleb T, Kajor M, Mazur W, Zych W, Walewska-Zielecka B, Habior A, Sobolewski M. Laboratory-based scoring system for prediction of hepatic inflammatory activity in patients with autoimmune hepatitis. Liver Int. 2013;33(9):1370-1377. https://doi.org/10.1111/liv.12198.
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