Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Saturday, 10 / 16 / 2021

Abstract

ORIGINAL ARTICLE

Characteristics and Inpatient Outcomes of Primary Biliary Cholangitis and Autoimmune Hepatitis Overlap Syndrome

Yi Jiang1,* , Bing-Hong Xu2 , Brandon Rodgers1; and Nikolaos Pyrsopoulos3,*

1  Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA
2  Liver Center & Center for Asian Health, RWJBH-Saint Barnabas Medical Center, Florham Park, New Jersey, USA
3  Division of Gastroenterology and Hepatology, Rutgers New Jersey Medical School, Newark, New Jersey, USA
*Correspondence to: Nikolaos Pyrsopoulos, Division of Gastroenterology and Hepatology, Rutgers-New Jersey Medical School, University Hospital, 185 S. Orange Avenue, Medical Science Building H level Room – 536, Newark, NJ 07101-1709, USA. ORCID:  https://orcid.org/0000-0002-6950-8174. Tel: +1-973-972-5252, E-mail:This email address is being protected from spambots. You need JavaScript enabled to view it. ; Yi Jiang, Department of Medicine, Rutgers-New Jersey Medical School, Newark, NJ 07101, USA. ORCID:https://orcid.org/0000-0001-5114-0183. Tel: +1-973-972-6056, E-mail:This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2021;9(3):392-398 DOI: 10.14218/JCTH.2021.00008
Received: January 2, 2021 Accepted: February 26, 2021 Published online: March 11, 2021

Abstract

Background and Aims:Primary biliary cholangitis (PBC) and autoimmune hepatitis (AIH) are hepatobiliary diseases of presumed immune-mediated origin that have been shown to overlap. The aim of this retrospective trial was to use national data to examine the characteristics and outcomes of patients hospitalized with overlapping PBC and AIH (PBC/AIH).

Methods:The National Inpatient Sample was used to identify hospitalized adult patients with PBC, AIH, and PBC/AIH from 2010 to 2014 by International Classification of Diseases-Ninth Edition Revision codes; patients with hepatitis B virus and hepatitis C virus infection were excluded. Primary outcomes measures were in-hospital outcomes that included mortality, respiratory failure, septic shock, length of stay, and total hospital charges. Secondary outcomes were the clinical characteristics of PBC/AIH, including the comorbid extrahepatic autoimmune disease pattern and complications of cirrhosis.

Results:A total of 3,478 patients with PBC/AIH were included in the study. PBC/AIH was associated with higher rates of Sjögren’s syndrome (p<0.001; p<0.001), lower rates of Crohn’s disease (p<0.05; p<0.05), and higher rates of cirrhosis-related complications when compared to PBC or AIH alone. There were similar rates of mortality between the PBC/AIH, PBC, and AIH groups. The PBC/AIH group had higher rates of septic shock when compared to the PBC group (p<0.05) and AIH group (p<0.05) after adjusting for possible confounders.

Conclusions:PBC/AIH is associated with a lower rate of Crohn’s disease, a higher rate of Sjögren’s syndrome, higher rates of cirrhosis-related complications, and significantly increased risk of septic shock compared to PBC and AIH individually.

Keywords

Primary biliary cholangitis, Autoimmune hepatitis, Extrahepatic autoimmune diseases, Cirrhosis-related complications, Septic shock, Hospital burden.

Journal of Clinical and Translational Hepatology 2021 vol. 9, 392-398  [ Html  ] [ PDF Full-text ]

© 2021 Authors. This is an Open Access article distributed under the terms of the  Creative Commons Attribution-Noncommercial 4.0 License(CC BY-NC 4.0), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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