Clinicopathologic features of the severe form of acute type 1 autoimmune hepatitis.
OBJECTIVE
Acute onset autoimmune hepatitis (acute AIH) is difficult to diagnose by using serologic data. In addition, some patients with the severe form of acute AIH do not respond to immunosuppressive therapy and have a poor outcome. In this study, we analyzed the clinicopathologic features of patients who were diagnosed as having acute AIH.


METHODS
Retrospective review of patients with presumed acute AIH at Ehime University Graduate School of Medicine was performed.


RESULTS
In liver tissue, infiltrates in the portal area and plasma cell infiltration are more common in acute AIH compared with acute hepatitis caused by other causes. Patients with acute AIH who did not have severe jaundice at the time of diagnosis exhibited a very good response to corticosteroid therapy, despite lower titers of antinuclear antibody (ANA). Most patients with acute AIH with higher levels of bilirubin and titers of ANA in sera respond poorly to corticosteroid therapy.


CONCLUSIONS
Histologic findings might be useful for the early diagnosis of acute AIH. Acute AIH patients with high levels of bilirubin and high titers of ANA in sera often do not respond to corticosteroid therapy.
Abe
Masanori
M
Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan.
Onji
Morikazu
M
Kawai-Ninomiya
Keiko
K
Michitaka
Kojiro
K
Matsuura
Bunzo
B
Hiasa
Yoichi
Y
Horiike
Norio
N
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood; D001663:Bilirubin / Q000097:blood; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D019693:Hepatitis, Autoimmune / Q000097:blood / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000276:immunology / Q000473:pathology*; D008875:Middle Aged; D012189:Retrospective Studies
D000974:Antibodies, Antinuclear; D005938:Glucocorticoids; D001663:Bilirubin