title: Comparison of clinical features and liver histology in acute and chronic autoimmune hepatitis.
abstract: OBJECTIVE
  We investigated the clinical and morphological features between acute and chronic autoimmune hepatitis (AIH) with or without acute exacerbation.
  
  
  RESULTS
  Serum total bilirubin on average was elevated to 12 mg/dL in acute AIH, alanine aminotransferase and aspartate aminotransferase peaked to more than 1000 U/L, and serum gamma-glutamyl transpeptidase was higher in the acute type compared with the chronic type without exacerbation. Serum immunoglobulin G was lowest in all other types of AIH. A liver biopsy showed interface or lobular hepatitis with lympho-plasmacytic infiltration, and rosette formations were frequently seen in acute AIH. There were morphological changes of central necrosis with plasmacytic infiltration and giant cell hepatitis. CK19-positive cholangiolar cells had proliferated in the periportal area with massive necrosis, and bile duct injuries were seen in acute AIH more frequently than in the chronic type.
  
  
  CONCLUSIONS
  Laboratory data and liver histology in acute AIH differed from those of chronic AIH and were clarified for the diagnosis of acute AIH.
authors: Departments of Molecular Gastroenterology Hepatology, Kyoto Prefectural University, Graduate School of Medical Science, Komigyo-ku, Kyoto, Japan.
authors: Masaki
authors: M
authors: Iwai
authors: Masayasu
authors: M
authors: Jo
authors: Michiaki
authors: M
authors: Ishii
authors: Takahiro
authors: T
authors: Mori
authors: Yoshinori
authors: Y
authors: Harada