Clinical Features of Cirrhosis in Japanese Patients with Type I Autoimmune Hepatitis
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- Abe Kazumichi
- Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Japan
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- Katsushima Fumiko
- Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Japan
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- Kanno Yukiko
- Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Japan
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- Takahashi Atsushi
- Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Japan
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- Yokokawa Junko
- Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Japan
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- Ohira Hiromasa
- Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Japan
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- Arinaga Teruko
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan
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- Ide Tatsuya
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan
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- Nishimura Junko
- Department of Internal Medicine, Oita University, Japan
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- Inoue Megumi
- Department of Internal Medicine, Oita University, Japan
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- Seike Masataka
- Department of Internal Medicine, Oita University, Japan
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- Imazeki Fumio
- Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, Japan
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- Yokosuka Osamu
- Department of Medicine and Clinical Oncology, Chiba University Graduate School of Medicine, Japan
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- Sata Michio
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan
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説明
Objective Autoimmune hepatitis (AIH) is a chronic inflammatory disorder of unknown etiology that may proceed to cirrhosis, although some patients already have cirrhosis at the time of AIH diagnosis. The aim of this study was to clarify the clinical characteristics of AIH patients with cirrhosis in Japan.<br> Methods Questionnaires were sent to liver specialists at four research facilities. Data for 250 patients diagnosed with AIH using the scoring system of the International Autoimmune Hepatitis Group (IAIHG) between 1975 and 2010 were collected and analyzed.<br> Results The male-to-female ratio was 1:8.3 and the average patient age was 55.6 years. Liver cirrhosis was found in 51 AIH patients (20.4%). Of these, 43 patients (84.3%) had cirrhosis at presentation and eight patients (15.7%) developed cirrhosis during the follow-up period (average follow-up of 82.1 months). There were significant differences between the two groups with and without cirrhosis at presentation with regard to age and biochemical parameters at presentation. There were no significant differences in histology, with the exception of liver fibrosis. The overall 10-year probability of survival was 71.2% vs. 99.3% in the patients with and without cirrhosis (log-rank test, p<0.001). The relapse rate was significantly higher in the patients who developed cirrhosis during treatment than in those who did not develop cirrhosis during treatment (100% vs. 7.5%, p<0.001).<br> Conclusion Since liver cirrhosis has already developed at presentation in many AIH patients with cirrhosis, it is important to diagnose the disease in the early stage and administer treatment rapidly with corticosteroids or immunosuppressants. In addition, a history of relapse is a risk factor for the development of cirrhosis in Japanese patients with AIH.<br>
収録刊行物
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- Internal Medicine
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Internal Medicine 51 (24), 3323-3328, 2012
一般社団法人 日本内科学会
