Clinical features of chronic liver disease with autoimmune blood diseases and the clinical effect of glucocorticoid

Long LIU; Yao LIU; Fangyuan GAO; Xianbo WANG

doi:10.3969/j.issn.1001-5256.2021.08.025

Volume 37 Issue 8

Aug. 2021

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Article Navigation > Journal of Clinical Hepatology > 2021 > 37(8): 1878-1882

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Clinical features of chronic liver disease with autoimmune blood diseases and the clinical effect of glucocorticoid

DOI: 10.3969/j.issn.1001-5256.2021.08.025

Department of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China

Research funding:

Capital's Funds for Health Improvement and Research (2018-1-2172);

Funded by Beijing Science and Technology Committee (Z191100006619033)

Received Date: 2021-03-04
Accepted Date: 2021-05-14
Published Date: 2021-08-20

Abstract

Abstract

Objective To investigate the clinical features of chronic liver disease with immune blood diseases and the clinical effect of glucocorticoid therapy. Methods A retrospective analysis was performed for the clinical data of 17 patients with chronic liver disease and immune blood diseases who were admitted to Beijing Ditan Hospital from January 2008 to December 2019, and according to the type of blood disease, they were divided into autoimmune hemolytic anemia (AIHA) group, immune thrombocytopenia (ITP) group, and Evans syndrome group. After glucocorticoid therapy and related treatment of liver disease, the three groups were compared in terms of clinical data and laboratory markers before and after treatment. The Mann-Whitney U test was used for comparison of continuous data between two groups. Results Among the 17 patients with chronic liver disease, 15 had no viral hepatitis, among whom 9 (52.9%) had autoimmune liver disease. Among these 17 patients, 6 had AIHA, 8 had ITP, and 3 had Evans syndrome. Glucocorticoid therapy was given for 13 patients, among whom12 achieved complete remission or partial remission, resulting in an overall response rate of 92.3%. After treatment, the ITP group had significant reductions in total bilirubin [35.8 (14.3-58.0) μmol/L vs 165.6 (21.3-374.3) μmol/L, Z=-2.205, P=0.027] and direct bilirubin [24.9 (7.0-43.3) μmol/L vs 121.9 (11.7-279.9) μmol/L, Z=-2.205, P=0.027], and the AIHA group had a significant increase in hemoglobin [94.0 (65.0-99.3) g/L vs 62.2 (42.3-80.5) g/L, Z=-2.242, P=0.025]. Conclusion Immune blood diseases are observed in patients with various types of chronic liver disease, among which autoimmune liver disease with immune blood diseases has a relatively high incidence rate. Glucocorticoid is a safe and effective therapeutic method for the treatment of chronic liver disease with immune blood diseases.
- Liver Diseases,
- Anemia, Hemolytic, Autoimmune,
- Purpura, Thrombocytopenic, Idiopathic,
- Evans Syndrome,
- Glucocorticoids

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[1]	SHAH AS, AMARAPURKAR DN. Spectrum of hepatitis B and renal involvement[J]. Liver Int, 2018, 38(1): 23-32. DOI: 10.1111/liv.13498.
[2]	WU R, LENG AM. Primary biliary cirrhosis with autoimmune hemolytic anemia: A case report[J]. J Clin Hepatol, 2020, 36(12): 2795-2797. DOI: 10.3969/j.issn.1001-5256.2020.12.030. 吴蓉, 冷爱民. 原发性胆汁性肝硬化合并自身免疫性溶血性贫血1例报告[J]. 临床肝胆病杂志, 2020, 36(12): 2795-2797. DOI: 10.3969/j.issn.1001-5256.2020.12.030.
[3]	Red Blood Cell Disease(Anemia) Group, Chinese Society of Hematology & Chinese Medical Association. Chinese expert consensus on the diagnosis and treatment of autoimmune hemolytic anemia(2017)[J]. China J Hematol, 2017, 38(4): 114-115. DOI: 10.3760/cma.j.issn.0253-2727.2017.04.001. 中华医学会血液病分会红细胞疾病(贫血)学组. 自身免疫性贫血诊断与治疗中国专家共识[J]. 中华血液学杂志, 2017, 38(4): 114-115. DOI: 10.3760/cma.j.issn.0253-2727.2017.04.001.
[4]	PETERMANN R. Platelet transfusion role in neonatal immune thrombocytopenia[J]. Transfus Clin Biol, 2016, 23(4): 217-221. DOI: 10.1016/j.tracli.2016.07.006.
[5]	Thrombosis and Hemostasis Group, Chinese Society of Hematology, Chinese Medical Association. Chinese guideline on the diagnosis and management of adult primary immune thrombocytopenia (2020)[J]. China J Hematol, 2020, 41(8): 617-623. DOI: 10.3760/cma.j.issn.0253-2727.2020.08.001. 中华医学会血液病分会血栓与止血学组. 成人原发免疫性血小板减少症诊断与治疗中国指南[J]. 中华血液学杂志, 2020, 41(8): 617-623. DOI: 10.3760/cma.j.issn.0253-2727.2020.08.001.
[6]	SYLVAIN A, NATACHA G, MORGANE M, et al. Evans' syndrome: From diagnosis to treatment[J]. J Clin Med, 2020, 9(12): 3851. DOI: 10.1542/peds.2010-2615.
[7]	SAAB S, BROWN RS Jr. Management of thrombocytopenia in patients with chronic liver disease[J]. Dig Dis Sci, 2019, 64(10): 2757-2768. DOI: 10.1007/s10620-019-05615-5.
[8]	FUKUDA H, TAKATA K, KITAGUCHI T, et al. Autoimmune hepatitis with concomitant idiopathic thrombocytopenic purpura diagnosed by transjugular liver biopsy[J]. Case Reports Hepatol, 2018, 2018: 5305691. DOI: 10.1155/2018/5305691.
[9]	PECK-RADOSAVLJEVIC M. Thrombocytopenia in chronic liver disease[J]. Liver Int, 2017, 37(6): 778-793. DOI: 10.1111/liv.13317.
[10]	NESCHADIM A, KOTRA LP, BRANCH DR. Small molecule phagocytosis inhibitors for immune cytopenias[J]. Autoimmun Rev, 2016, 15(8): 843-847. DOI: 10.1016/j.autrev.2016.06.004.
[11]	ITO A, YOSHIZAWA K, FUJIMORI K, et al. Autoimmune hepatitis associated with immune thrombocytopenic purpura[J]. Intern Med, 2017, 56(2): 143-147. DOI: 10.2169/internalmedicine.56.7506.
[12]	CHEN Z, ZHANG L, LIU J, et al. Analysis on expression level of PD-1 on the surface of CD4⁺T lymphocytes in peripheral blood of patients with primary immune thrombocytopenia[J]. China Med Herald, 2021, 18(1): 92-95. 陈哲, 张灵, 刘洁, 等. 原发免疫性血小板减少症患者外周血CD4⁺T淋巴细胞表面PD-1表达水平分析[J]. 中国医药导报, 2021, 18(1): 92-95.
[13]	KORKMAZ H, BUGDACI MS, TEMEL T, et al. Autoimmune hepatitis-primary biliary cirrhosis overlap syndrome concomitant with immune hemolytic anemia and immune thrombocytopenic purpura (Evans syndrome)[J]. Clin Res Hepatol Gastroenterol, 2013, 37(2): e45-e50. DOI: 10.1016/j.clinre.2012.11.001.
[14]	BIANCO C, COLUCCIO E, PRATI D, et al. Diagnosis and management of autoimmune hemolytic anemia in patients with liver and bowel disorders[J]. J Clin Med, 2021, 10(3): 423. DOI: 10.3390/jcm10030423.
[15]	ABDELA J. Current advance in thrombopoietin receptor agonists in the management of thrombocytopenia associated with chronic liver disease: Focus on avatrombopag[J]. Clin Med Insights Blood Disord, 2019, 12: 1179545X19875105. DOI: 10.1177/1179545X19875105.
[16]	SAMSON M, FRASER W, LEBOWITZ D. Treatments for primary immune thrombocytopenia: A review[J]. Cureus, 2019, 11(10): e5849. DOI: 10.7759/cureus.5849.
[17]	PECK-RADOSAVLJEVIC M. Thrombocytopenia in chronic liver disease[J]. Liver Int, 2017, 37(6): 778-793. DOI: 10.1111/liv.13317.
[18]	WANG SC, YANG KD, LIN CY, et al. Intravenous immunoglobulin therapy enhances suppressive regulatory T cells and decreases innate lymphoid cells in children with immune thrombocytopenia[J]. Pediatr Blood Cancer, 2020, 67(2): e28075. DOI: 10.1002/pbc.28075.
[19]	LEE JB, PARK HS, PARK S, et al. Temsirolimus in Asian metastatic/recurrent non-clear cell renal carcinoma[J]. Cancer Res Treat, 2019, 51(4): 1578-1588. DOI: 10.4143/crt.2018.671.

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Clinical features of chronic liver disease with autoimmune blood diseases and the clinical effect of glucocorticoid

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Clinical features of chronic liver disease with autoimmune blood diseases and the clinical effect of glucocorticoid

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