Imperial College London
Alternate

ProfessorMarkThursz

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Hepatology. Head of Department
 
 
 
//

Contact

 

+44 (0)20 3312 1903m.thursz

 
 
//

Assistant

 

Ms Dawn Campbell +44 (0)20 3312 6454

 
//

Location

 

Norfolk PlaceSt Mary's Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Forrest:2021:10.1111/apt.16157,
author = {Forrest, E and Petts, G and Austin, A and Lloyd, K and Wright, M and Vergis, N and Atkinson, S and Masson, S and Patch, D and Quaglia, A and Thursz, M and Goldin, R},
doi = {10.1111/apt.16157},
journal = {Alimentary Pharmacology and Therapeutics},
pages = {426--431},
title = {The diagnostic and prognostic significance of liver histology in alcoholic hepatitis},
url = {http://dx.doi.org/10.1111/apt.16157},
volume = {53},
year = {2021}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundLiver biopsy may be of diagnostic and prognostic value but its role in alcoholic hepatitis (AH) has been controversial.AimTo assess the utility of liver biopsy in the assessment of clinically severe AHMethodsThe histological features of alcoholic steatohepatitis (ASH) were recorded and scored in patients enrolled in the Steroids or Pentoxifylline for Alcoholic Hepatitis (STOPAH) trial who underwent liver biopsy. These features were then assessed relative to outcome and established clinical prognostic scores.ResultsThe STOPAH trial recruited 1068 patients; biopsies were obtained in 182 (17%). One hundred and sixtyone biopsies were adequate for histological assessment and 140 (87%) were diagnostic for ASH. Only three biopsies (2%) did not have histological features of alcoholrelated liver injury. In biopsies performed prior to randomisation, ASH was identified in 92.5% of patients meeting clinical trial definitions of severe AH. In biopsies with ASH, taken before or within 48 hours of randomisation, survival differences between Alcoholic Hepatitis Histological Score (AHHS) groups were not significant: comparison of mild / moderate (91%: 21 of 23 patients) with severe (78%: 29 of 37 patients) groups: P = 0.18. The AHHS was not superior to clinical scores of prognosis: area under the curve for 28day mortality was 0.728, compared with 0.799 for the Glasgow alcoholic hepatitis score and 0.728 for the MELD score.ConclusionLiver histology taken before treatment rarely changes the diagnosis in patients meeting strict criteria for a clinical diagnosis of AH. The AHHS is similar to clinical scores in determining prognosis.Clinical trial registrationEudraCT reference number: 200901389742.ISRCTN reference number: 88782125.MREC number: 09/MRE09/59.UKCRIN ID: 9143.
AU  - Forrest,E
AU  - Petts,G
AU  - Austin,A
AU  - Lloyd,K
AU  - Wright,M
AU  - Vergis,N
AU  - Atkinson,S
AU  - Masson,S
AU  - Patch,D
AU  - Quaglia,A
AU  - Thursz,M
AU  - Goldin,R
DO  - 10.1111/apt.16157
EP  - 431
PY  - 2021///
SN  - 0269-2813
SP  - 426
TI  - The diagnostic and prognostic significance of liver histology in alcoholic hepatitis
T2  - Alimentary Pharmacology and Therapeutics
UR  - http://dx.doi.org/10.1111/apt.16157
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000599014800001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://onlinelibrary.wiley.com/doi/full/10.1111/apt.16157
UR  - http://hdl.handle.net/10044/1/85474
VL  - 53
ER  -
Download