Clinical implications of antimitochondrial antibodies in type 1 autoimmune hepatitis: a longitudinal study.
OBJECTIVE
Autoimmune hepatitis (AIH) is a chronic liver disease characterized by the presence of antinuclear antibodies. However, antimitochondrial antibodies (AMA) and bile duct changes, which are the characteristics of primary biliary cirrhosis (PBC), can be detected in AIH patients.


METHODS
Twenty patients with definite AIH were prospectively followed-up, and the serial changes in AMA profiles were determined. We also examined the correlations between these antibodies and histopathological findings in the liver.


RESULTS
Of the 20 patients, 7 (35%) had bile duct injury, and 2 of these 7 patients also showed chronic nonsuppurative destructive cholangitis or ductopenia of interlobular bile ducts histopathologically. Serologically, 7 patients (35%) were positive for AMA at least once by immunoblotting during the follow-up periods. There were no significant differences in biochemical hepatobiliary indices, the presence of bile duct lesions, or the changes in biochemical profiles between AMA-positive and AMA-negative AIH patients during the follow-up periods.


CONCLUSIONS
We confirmed that AMA and certain histopathological findings that are characteristics of PBC can be seen in some AIH patients. However, there was no significant correlation between AMA positivity and the histopathological findings in the liver, or biochemical hepatobiliary indices. Thus, the clinical implications of AMA in AIH patients remain unclear.
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan.
Shiho
S
Mishima
Katsuhisa
K
Omagari
Kazuo
K
Ohba
Yoshiko
Y
Kadokawa
Jun-ichi
J
Masuda
Ryosuke
R
Mishima
Hideki
H
Kinoshita
Kenji
K
Hayashida
Hajime
H
Isomoto
Saburo
S
Shikuwa
Yohei
Y
Mizuta
Shigeru
S
Kohno
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D019693:Hepatitis, Autoimmune / Q000276:immunology* / Q000503:physiopathology; D006801:Humans; D015151:Immunoblotting; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D008930:Mitochondria, Liver / Q000276:immunology*
D001323:Autoantibodies