McFarlane I G, Hegarty J E, McSorley C G, McFarlane B M, Williams R
Lancet. 1984 Oct 27;2(8409):954-6. doi: 10.1016/s0140-6736(84)91167-x.
The value of serum autoantibodies against the liver-specific membrane lipoprotein (LSP) complex in predicting the outcome of treatment withdrawal was assessed in 22 patients with autoimmune chronic active hepatitis who had been maintained in remission on azathioprine and/or prednisolone. At the start of treatment withdrawal 8 patients had anti-LSP antibodies. Within 7-20 weeks (median 12 weeks) all 8 showed biochemical (aminotransferase greater than 200 IU/l) amd histological (piecemeal necrosis) evidence of reactivation of disease. Of the remaining 14 patients, who did not have anti-LSP antibodies at the start of treatment withdrawal, 8 became seropositive within 2-13 weeks (median 6 weeks) and all 8 had relapsed by 21 weeks. In 7 of these eight, anti-LSP first appeared 3 to 10 weeks (median 6 weeks) before and, in the eighth, coincident with biochemical evidence of relapse. The remaining 6 patients continued to be anti-LSP negative and showed no evidence of reactivation of disease throughout the study period (median 29 weeks, range 26-32 weeks). The results show that the presence of anti-LSP antibodies in patients who are apparently in complete remission is invariably associated with reactivation of disease during treatment withdrawal.
在22例接受硫唑嘌呤和/或泼尼松龙维持缓解的自身免疫性慢性活动性肝炎患者中，评估了抗肝特异性膜脂蛋白（LSP）复合物血清自身抗体在预测撤药治疗结果方面的价值。在撤药治疗开始时，8例患者有抗LSP抗体。在7 - 20周内（中位数为12周），所有8例患者均出现疾病复发的生化证据（转氨酶大于200 IU/L）和组织学证据（碎片状坏死）。在撤药治疗开始时没有抗LSP抗体的其余14例患者中，8例在2 - 13周内（中位数为6周）血清学转为阳性，并且所有8例在21周时均复发。在这8例中的7例中，抗LSP首次出现在复发生化证据出现前3至10周（中位数为6周），在第8例中，与复发生化证据同时出现。其余6例患者在整个研究期间（中位数为29周，范围26 - 32周）持续为抗LSP阴性，且无疾病复发证据。结果表明，明显完全缓解的患者中抗LSP抗体的存在总是与撤药治疗期间的疾病复发相关。
