{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T17:25:50Z","timestamp":1789233950133,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T00:00:00Z","timestamp":1715385600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Acute severe autoimmune hepatitis (AS\u2010AIH) is an evolving concept and the outcomes and optimal treatment have been less studied. In this study, we aimed to investigate the outcomes of patients with AS\u2010AIH and predictors of non\u2010response to corticosteroid therapy and need for liver transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a retrospective cohort, we included patients with AS\u2010AIH admitted to our liver center. We defined AS\u2010AIH based on the international autoimmune hepatitis group score as acute presentation of AIH with an international normalized ratio (INR)\u00a0\u2265\u00a01.5 and without liver cirrhosis and hepatic encephalopathy. All patients received high dose corticosteroid therapy. Treatment response was defined as liver transplant free survival at 4\u00a0months after presentation. Factors associated with response to corticosteroids and survival of patients were studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 61 patients with AS\u2010AIH were included. Forty\u2010seven patients responded to corticosteroid therapy. In the multivariate regression model, baseline INR (odds ratio [OR]: 0.184; 95% confidence interval [CI]: 0.048\u20130.699;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.013) and delayed versus early initiation of corticosteroid (after vs. before 5\u00a0days of presentation) (OR: 0.189; 95% CI: 0.039\u20130.919;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.039) were independent predictors of clinical non\u2010response to corticosteroid therapy. In the multivariable Cox regression model, baseline INR level (hazard ratio [HR]: 2.542; 95% CI: 1.188\u20135.440;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.016) and delayed initiation of corticosteroids (HR: 3.578; 95% CI: 1.084\u201311.812;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.036) were independent predictors of liver transplant free survival at 6\u00a0months after diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Delayed initiation of corticosteroid therapy might be predictive of clinical non\u2010response to medical therapy and need for liver transplantation in patients with AS\u2010AIH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.12582","type":"journal-article","created":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T08:09:08Z","timestamp":1715414948000},"page":"911-918","source":"Crossref","is-referenced-by-count":6,"title":["Outcomes of patients with acute severe autoimmune hepatitis: Predictors of non\u2010response to corticosteroids and need for liver transplantation"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0751-5712","authenticated-orcid":false,"given":"Ahad","family":"Eshraghian","sequence":"first","affiliation":[{"name":"Shiraz Transplant Center Avicenna Hospital  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5360-6776","authenticated-orcid":false,"given":"Alireza","family":"Taghavi","sequence":"additional","affiliation":[{"name":"Shiraz Transplant Center Avicenna Hospital Shiraz University of Medical Sciences  Shiraz Iran"},{"name":"Department of Gastroenterology and Hepatology Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9729-7546","authenticated-orcid":false,"given":"Saman","family":"Nikeghbalian","sequence":"additional","affiliation":[{"name":"Shiraz Transplant Center Avicenna Hospital Shiraz University of Medical Sciences  Shiraz Iran"},{"name":"Department of Hepatobiliary Pancreatic and Transplant Surgery Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,11]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0000000000000701"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.14746"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21884"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e318228b781"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41423\u2010021\u201000768\u20108"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cld.1231"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2018.17"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14513"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.1552"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0168\u20108278(99)80297\u20109"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.12.033"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.05.021"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.25906"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21036"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.03.023"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876\u2010021\u201001653\u20104"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16926"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2022.08.035"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2018.02.015"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24141"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2020.100149"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.06.006"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000000353"}],"container-title":["United European Gastroenterology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ueg2.12582","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T16:01:14Z","timestamp":1764518474000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ueg2.12582"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,11]]},"references-count":23,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1002\/ueg2.12582"],"URL":"https:\/\/doi.org\/10.1002\/ueg2.12582","archive":["Portico"],"relation":{},"ISSN":["2050-6406","2050-6414"],"issn-type":[{"value":"2050-6406","type":"print"},{"value":"2050-6414","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,11]]}}}