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Autoimmune hepatitis in Japan: trends in a nationwide survey

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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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.

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Acknowledgments

This study was conducted and supported by Health Labor Science Research grants from Research on Measures for Intractable Diseases, the Intractable Hepato-Biliary Diseases Study Group in Japan.

In addition to the authors, the hepatology specialists who participated in this study and the contributors to this study were as follows: Masahito Minami (Aiseikai Yamashina Hospital), Hikaru Nagahara (Aoyama Hospital Tokyo Women’s Medical University), Shiro Yokohama (Asahikawa Medical Center), Koji Sawada (Asahikawa Medical University), Takato Ueno (Asakura Medical Association Hospital), Yuki Haga (Chiba University), Chiharu Miyabayashi (Chikuma Central Hospital), Masaya Tamano (Dokkyo Medical University Koshigaya Hospital), Yasuaki Takeyama (Fukuoka University), Kenji Imai (Gifu University Hospital), Yuichi Yamazaki (Gunma University Hospital), Kazuhito Kawata (Hamamatsu University School of Medicine), Hiroshi Aikata (Hiroshima University Hospital), Koji Ogawa (Hokkaido University), Shuhei Nishiguchi (Hyogo College of Medicine), Akihide Masumoto (Iizuka Hospital), Toshihiko Mizuta (Imari Arita Kyoritsu Hospital), Kojiro Kataoka (Iwate Medical University School of Medicine), Chitomi Hasebe (Japanese Red Cross Asahikawa Hospital), Hiroshi Watanabe (Japanese Red Cross Fukuoka Hospital), Hideki Fujii (Japanese Red Cross Kyoto Daiichi Hospital), Hiroo Fukada (Juntendo University Nerima Hospital), Kazuyoshi Kon (Juntendo University School of Medicine),Takuya Genda (Juntendo University Shizuoka Hospital), Takako Nomura (Kagawa University Hospital), Mikihiro Tsutsumi (Kanazawa Medical University), Miki Murata (Kansai Medical University Medical Center), Kazuya Kitamura (Kanazawa University Hospital), Nobuko Koyama (Kawasaki Medical School), Shinji Iwasaki (Kochi University), Takeshi Kawasaki (Kumamoto University Hospital), Kouju Kobayashi (Kurihara Central Hospital), Hitoshi Takagi (Kusunoki Hospital), Yuya Seko (Kyoto Prefectural University of Medicine), Yuki Bekki (Kyushu University), Shinji Shimoda (Kyushu University Hospital), Hisashi Takayama (Maebashi Red Cross Hospital),Yasuyuki Nagao (Matsushita Memorial Hospital), Toshie Mashiba (Matsuyama Red Cross Hospital), Kiyohiko Kishi (Meiwa General Hospital), Naoya Murashima (Mishuku Hospital), Motoshige Nabeshima (Mitsubishi Kyoto Hospital), Akihiro Obora (Murakami Memorial Hospital Asahi University), Atsumasa Komori (Nagasaki Medical Center), Hidetaka Shibata (Nagasaki University Hospital), Yasuyo Morita (Nagata Hospital), Saiyu Tanaka (Nara City Hospital), Kei Moriya (Nara Medical University), Kengo Tomita (National Defense Medical Colledge Hospital), Toshiki Yamamoto (Nihon University Hospital), Kentarou Igarashi (Niigata City General Hospital), Satoshi Yamagiwa (Niigata University), Daisuke Watanabe (Noshiro Yamamoto Medical Association Hospital), Akira Kaneko (NTT Osaka Hospital), Shinya Yokoyama (Ogaki Municipal Hospital), Tomohiko Suzuki (Ohkubo Hospital), Shinichi Fujioka (Okayama Saiseikai General Hospital), Mie Arakawa (Oita University Hospital), Kazunori Noguchi (Omuta City Hospital), Norifumi Kawada (Osaka City University Graduate School of Medicine), Takatoshi Nawa (Osaka Medical Center for Cancer and Cardiovascular Diseases), Hideko Ohama (Osaka Medical College Hospital), Kunimaro Furuta (Osaka University), Shiro Takami (Otsu Municipal Hospital), Taiga Otsuka (Saga University Hospital), Atsushi Nakazawa (Saiseikai Central Hospital), Morikazu Onji (Saiseikai Imabari Hospital), Shigeru Matsui (Saiseikai Kawaguchi General Hospital), Fujimasa Tada (Saiseikai Matsuyama Hospital), Sumiko Nagoshi (Saitama Medical Center), Mie Inao (Saitama Medical University), Yoshinori Horie (Sanno Medical Center), Tomoaki Nakajima (Sapporo-Kosei General Hospital), Hideyasu Takagi (Sapporo Medical University Hospital), Takeji Umemura (Shinshu University School of Medicine), Toshiyuki Baba (Showa University Northern Yokohama Hospital), Naoki Yamashita (Steel Memorial Yawata Hospital), Hiroshi Okano (Suzuka General Hospital), Atsushi Naganuma (Takasaki General Medical Center), Kentaro Kikuchi (Teikyo University Hospital, Mizonokuchi), Kazuhiko Koike (The Jikei University Daisan Hospital), Yoshio Aizawa (The Jikei University Katsushika Medical Center), Shougo Ohkoshi (The Nippon Dental University), Ryo Nakagomi, Tomohiro Tanaka (The University of Tokyo Hospital), Mie Shinohara (Toho University Omori Medical Center), Yutaka Miyazaki (Tohoku Kosai Hospital), Yu Nakagome (Tohoku University Hospital), Mitsunori Morimatsu (Tokuyama Medical Association Hospital), Tadashi Ikegami (Tokyo Medical University Ibaraki Medical Center), Naoaki Hashimoto (Tokyo Teishin Hospital), Masahiko Koda (Tottori University Hospiital), Tomoyuki Nemoto (University of Fukui Hospital), Masami Minemura (Toyama University Hospital), Yoshiyuki Mori (Wakayama Medical University), Kazuo Okumoto (Yamagata University), Yasuhiro Funayama (Yamagata City Hospital SAISEIKAN), Isao Hidaka (Yamaguchi University), Noriyuki Ono (Yame General Hospital), Takaaki Ikeda (Yokosuka Kyosai Hospital).

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Atsushi Takahashi & Hiromasa Ohira

  2. Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan

    Teruko Arinaga-Hino & Takuji Torimura

  3. Sanno Medical Center, International University of Health and Welfare, 8-10-16 Akasaka, Minato-ku, Tokyo, 107-0052, Japan

    Mikio Zeniya

  4. Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, To-on, Ehime, 791-0295, Japan

    Masanori Abe

  5. Department of Gastroenterology, National Hospital Organization, Shinshu Ueda Medical Center, 1-27-21 Midorigaoka, Ueda, Nagano, 386-8610, Japan

    Kaname Yoshizawa

  6. 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

    Akinobu Takaki

  7. Department of Hepatology, Toranomon Hospital, Toranomon 2-2-2, Minato-ku, Tokyo, 105-8470, Japan

    Yoshiyuki Suzuki

  8. Center for Gastroenterology, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan

    Jong-Hon Kang

  9. Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Nobuhiro Nakamoto

  10. Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohama Tobu Hospital, 6-1 Shimosueyoshi 3-Chome, Tsurumi-ku, Yokohama, Kanagawa, 230-0012, Japan

    Tomoo Fujisawa

  11. Biostatistics Center, Kurume University, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan

    Koji Yonemoto

  12. Department of Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173-8605, Japan

    Atsushi Tanaka & Hajime Takikawa

Authors
  1. Atsushi Takahashi
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  2. Teruko Arinaga-Hino
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  3. Hiromasa Ohira
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  4. Takuji Torimura
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  5. Mikio Zeniya
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  6. Masanori Abe
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  7. Kaname Yoshizawa
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  8. Akinobu Takaki
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  9. Yoshiyuki Suzuki
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  10. Jong-Hon Kang
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  11. Nobuhiro Nakamoto
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  12. Tomoo Fujisawa
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  13. Koji Yonemoto
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  14. Atsushi Tanaka
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  15. Hajime Takikawa
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Consortia

Autoimmune Hepatitis Study Group-Subgroup of the Intractable Hepato-Biliary Disease Study Group in Japan

Corresponding author

Correspondence to Atsushi Takahashi.

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Conflict of interest

Yoshiyuki Suzuki received lecture fees from Bristol-Myers Squibb. The other authors declare that they have no conflict of interest.

Additional information

The authors in the Autoimmune Hepatitis Study Group, a subgroup of the Intractable Hepato-Biliary Disease Study Group in Japan, are listed in “Acknowledgments.”

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Takahashi, A., Arinaga-Hino, T., Ohira, H. et al. Autoimmune hepatitis in Japan: trends in a nationwide survey. J Gastroenterol 52, 631–640 (2017). https://doi.org/10.1007/s00535-016-1267-0

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  • DOI: https://doi.org/10.1007/s00535-016-1267-0

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