title: Immunoglobulin G4-associated autoimmune hepatitis may be found in Western countries.
abstract: BACKGROUND
  Immunoglobulin G4-related disease is a multi-systemic autoimmune disease. The sole involvement of the liver has been recently reported in Japanese patients and named "immunoglobulin G4-associated autoimmune hepatitis".
  
  
  OBJECTIVE
  To examine the baseline and the 2-year follow-up characteristics of non-Asian patients with immunoglobulin G4-associated autoimmune hepatitis compared to patients with classical autoimmune hepatitis.
  
  
  METHODS
  This was a retrospective study of patients who had undergone liver biopsy between March 2009 and January 2012 before starting any treatment. All patients were treated according to the guidelines. Immunoglobulin G4-associated autoimmune hepatitis was diagnosed according to Umemura's histological definition: at least 10 positive immunoglobulin G4-plasma cells per high power field.
  
  
  RESULTS
  Among 28 enrolled patients (males 39%, median age 54 years): 7 had immunoglobulin G4-associated autoimmune hepatitis (25%) and 21 had classical hepatitis; fibrosis and activity stages were F1: 57%, F2: 11%, F3: 11%, F4: 21% and A1: 18%, A2: 39%, A3: 43%. Alanine aminotransferase (ALT) activity and serum immunoglobulin G levels were similar in the two groups at baseline and at 2 years. Complete biochemical response (normal ALT) was similar in immunoglobulin G4-associated autoimmune hepatitis and classical hepatitis (67% vs. 59% at 2 years, p=0.74).
  
  
  CONCLUSIONS
  Immunoglobulin G4-associated autoimmune hepatitis has been observed in Western patients and seems to evolve in a similar manner to classical hepatitis.
authors.affiliation: University Hospital of Nice, Digestive Centre, Nice, France; National Institute of Health and Medical Research (INSERM), U1065, Team 8, "Hepatic Complications in Obesity", Nice, France; University of Nice-Sophia-Antipolis, College of Medicine, Nice, France.
authors.forename: Clémence M
authors.initials: CM
authors.lastname: Canivet
authors.affiliation: University Hospital of Nice, Digestive Centre, Nice, France; National Institute of Health and Medical Research (INSERM), U1065, Team 8, "Hepatic Complications in Obesity", Nice, France; University of Nice-Sophia-Antipolis, College of Medicine, Nice, France. Electronic address: anty.r@chu-nice.fr.
authors.forename: Rodolphe
authors.initials: R
authors.lastname: Anty
authors.affiliation: University Hospital of Nice, Digestive Centre, Nice, France; University of Nice-Sophia-Antipolis, College of Medicine, Nice, France; University Hospital of Nice, Biological Center, Nice, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Patouraux
authors.affiliation: University Hospital of Nice, Biological Center, Nice, France.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Saint-Paul
authors.affiliation: National Institute of Health and Medical Research (INSERM), U1065, Team 8, "Hepatic Complications in Obesity", Nice, France; University of Nice-Sophia-Antipolis, College of Medicine, Nice, France.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Lebeaupin
authors.affiliation: National Institute of Health and Medical Research (INSERM), U1065, Team 8, "Hepatic Complications in Obesity", Nice, France; University of Nice-Sophia-Antipolis, College of Medicine, Nice, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gual
authors.affiliation: Hepato-biliary Centre, Paul Brousse, Villejuif, DHU Hepatinov, France.
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Duclos-Vallee
authors.affiliation: University Hospital of Nice, Digestive Centre, Nice, France; National Institute of Health and Medical Research (INSERM), U1065, Team 8, "Hepatic Complications in Obesity", Nice, France; University of Nice-Sophia-Antipolis, College of Medicine, Nice, France.
authors.forename: Albert
authors.initials: A
authors.lastname: Tran
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D062005:Biopsy, Large-Core Needle; D005260:Female; D005602:France / Q000453:epidemiology; D019693:Hepatitis, Autoimmune / Q000097:blood / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D007074:Immunoglobulin G; D000410:Alanine Transaminase
keywords: Autoimmune hepatitis; Immunoglobulin G; Immunoglobulin G4-associated autoimmune hepatitis; Plasma cells