How reversible is hepatic functional impairment in autoimmune hepatitis?

GROUND AND AIMS: We quantifed the short-term effects of immunosuppressive therapy on hepatic metabolic function in autoimmune hepatitis to establish how long it takes to achieve maximum functional improvement. METHODS: We studied 14 newly diagnosed patients with autoimmune hepatitis (12 type 1, two type 2) by antipyrine clearance and conventional liver tests, then repeated studies at 3-6 month intervals during the first 18 months of immunosuppressive therapy. RESULTS: Low values for antipyrine clearance were found in 13 of 14 cases; serum albumin concentration was low in four, bilirubin raised in eight and prothrombin time prolonged in four.

Following immunosuppressive treatment for 3 months, antipyrine clearance improved by 98% (standard error of the mean 24%), which was proportionally greater than for serum albumin, bilirubin or prothrombin time. Antipyrine clearance and serum albumin continued to improve after 6-12 months of immunosuppressive treatment in several cases, whereas ... more.

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