Clinical Features of Cirrhosis in Japanese Patients with Type I Autoimmune Hepatitis
スポンサーリンク
概要
- 論文の詳細を見る
Objective Autoimmune hepatitis (AIH) is a chronic inflammatory disorder of unknown etiology that may proceed to cirrhosis, although some patients already have cirrhosis at the time of AIH diagnosis. The aim of this study was to clarify the clinical characteristics of AIH patients with cirrhosis in Japan. Methods Questionnaires were sent to liver specialists at four research facilities. Data for 250 patients diagnosed with AIH using the scoring system of the International Autoimmune Hepatitis Group (IAIHG) between 1975 and 2010 were collected and analyzed. Results The male-to-female ratio was 1:8.3 and the average patient age was 55.6 years. Liver cirrhosis was found in 51 AIH patients (20.4%). Of these, 43 patients (84.3%) had cirrhosis at presentation and eight patients (15.7%) developed cirrhosis during the follow-up period (average follow-up of 82.1 months). There were significant differences between the two groups with and without cirrhosis at presentation with regard to age and biochemical parameters at presentation. There were no significant differences in histology, with the exception of liver fibrosis. The overall 10-year probability of survival was 71.2% vs. 99.3% in the patients with and without cirrhosis (log-rank test, p<0.001). The relapse rate was significantly higher in the patients who developed cirrhosis during treatment than in those who did not develop cirrhosis during treatment (100% vs. 7.5%, p<0.001). Conclusion Since liver cirrhosis has already developed at presentation in many AIH patients with cirrhosis, it is important to diagnose the disease in the early stage and administer treatment rapidly with corticosteroids or immunosuppressants. In addition, a history of relapse is a risk factor for the development of cirrhosis in Japanese patients with AIH.
著者
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Ide Tatsuya
Division Of Gastroenterology Department Of Medicine Kurume University School Of Medicine
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Inoue Megumi
Department Of Acoustic Design Kyushu Institute Of Design
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Imazeki Fumio
Department Of Medicine And Clinical Oncology Graduate School Of Medicine Chiba University
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Seike Masataka
Department Of Gastroenterology Oita University Faculty Of Medicine
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Sata Michio
Division Of Clinical Nutrition Shiga University Of Medical Science
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Abe Kazumichi
Department Of Gastroenterology And Rheumatology Fukushima Medical University School Of Medicine
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Yokokawa Junko
Department Of Gastroenterology And Rheumatology Fukushima Medical University School Of Medicine
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KATSUSHIMA Fumiko
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine
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Nishimura Junko
Department Of Internal Medicine1 Faculty Of Medicine Oita University
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Takahashi Atsushi
Departmant Of Surgery(i) Kanazawa University School Of Medicine
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OHIRA HIROMASA
Department of Gastroenterology and Rheumatology
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YOKOSUKA Osamu
Department of Gastroenterology and Clinical Oncology, Graduate School of Medicine, Chiba University
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Kanno Yukiko
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Japan
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Seike Masataka
Department of Internal Medicine, Oita University, Japan
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Arinaga Teruko
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan
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Katsushima Fumiko
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Japan
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Abe Kazumichi
Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Japan
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Ide Tatsuya
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Japan
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Nishimura Junko
Department of Internal Medicine, Oita University, Japan
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