title: Autoimmune hepatitis in Japan: trends in a nationwide survey.
abstract: BACKGROUND
  A nationwide survey of autoimmune hepatitis (AIH) patients was performed in Japan in 2015. The aims of this study were to elucidate the trends and characteristics of AIH in Japan, in addition to identifying differences in AIH between acute hepatitis and chronic hepatitis.
  
  
  METHODS
  Questionnaires about patients with AIH diagnosed from 2009 to 2013 were sent to 437 hospitals or clinics with hepatology specialists.
  
  
  RESULTS
  A total of 1682 patients were enrolled. The mean age at diagnosis was 60.0 years, and 87.1 % of patients were female. Serum immunoglobulin G levels were high, peaking at 1.5-2.0 g/dL. Histological diagnoses of chronic hepatitis, acute hepatitis, and cirrhosis were seen in 79.6, 11.7, and 6.7 % of patients respectively. In addition to elevation of aminotransferase levels, the frequencies of emperipolesis and human leukocyte antigen (HLA)-DR2 positivity were higher in patients with acute hepatitis than in those with chronic hepatitis. Approximately 80 % of patients were treated with corticosteroids, and in 97.7 % of them, their condition improved. Steroid pulse therapy was more frequently given to patients with acute hepatitis than to those with chronic hepatitis.
  
  
  CONCLUSIONS
  In the present nationwide survey of AIH patients in Japan, patients with acute hepatitis had clinical features different from those of patients with chronic hepatitis.
authors.affiliation: Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan. junior@fmu.ac.jp.
authors.forename: Atsushi
authors.identifier: http://orcid.org/0000-0003-0568-8361
authors.initials: A
authors.lastname: Takahashi
authors.affiliation: Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
authors.forename: Teruko
authors.initials: T
authors.lastname: Arinaga-Hino
authors.affiliation: Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
authors.affiliation: Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Torimura
authors.affiliation: Sanno Medical Center, International University of Health and Welfare, 8-10-16 Akasaka, Minato-ku, Tokyo, 107-0052, Japan.
authors.forename: Mikio
authors.initials: M
authors.lastname: Zeniya
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, To-on, Ehime, 791-0295, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
authors.affiliation: Department of Gastroenterology, National Hospital Organization, Shinshu Ueda Medical Center, 1-27-21 Midorigaoka, Ueda, Nagano, 386-8610, Japan.
authors.forename: Kaname
authors.initials: K
authors.lastname: Yoshizawa
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
authors.forename: Akinobu
authors.initials: A
authors.lastname: Takaki
authors.affiliation: Department of Hepatology, Toranomon Hospital, Toranomon 2-2-2, Minato-ku, Tokyo, 105-8470, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Center for Gastroenterology, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan.
authors.forename: Jong-Hon
authors.initials: JH
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Nakamoto
authors.affiliation: Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohama Tobu Hospital, 6-1 Shimosueyoshi 3-Chome, Tsurumi-ku, Yokohama, Kanagawa, 230-0012, Japan.
authors.forename: Tomoo
authors.initials: T
authors.lastname: Fujisawa
authors.affiliation: Biostatistics Center, Kurume University, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yonemoto
authors.affiliation: Department of Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Department of Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Takikawa
mesh_terms: D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D019538:Health Care Surveys; D006306:Health Surveys; D019693:Hepatitis, Autoimmune / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D006521:Hepatitis, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D011364:Professional Practice / Q000639:trends; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D014580:Ursodeoxycholic Acid; D011239:Prednisolone
keywords: Acute hepatitis; Autoimmune hepatitis; Nationwide survey