Clinical features of Japanese type 1 autoimmune hepatitis patients with zone III necrosis

Yasuhiro Miyake, Yoshiaki Iwasaki, Ryo Terada, Toru Onishi, Ryoichi Okamoto, Kouichi Takaguchi, Hiroshi Ikeda, Yasuhiro Makino, Haruhiko Kobashi, Kohsaku Sakaguchi, Yasushi Shiratori

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Aim: In Caucasians in northern Europe and North America, type 1 autoimmune hepatitis is characterized by susceptibility to human leukocyte antigens DR3 and DR4, and patients with zone III necrosis more frequently have an acute onset of the disease and a lower frequency of cirrhosis than those without. In Japanese patients, however, type 1 autoimmune hepatitis is primarily associated with DR4, and there are almost no DR3-positive patients. Thus, the clinical features of Japanese patients with type 1 autoimmune hepatitis and zone III necrosis may be different from those reported previously for Caucasians. Methods: We investigated 160 consecutive patients with type 1 autoimmune hepatitis (20 males and 140 females; median age, 55 years; range, 16-79 years). Results: Forty-seven patients (29%) had zone III necrosis, and these patients had lower serum levels of albumin and higher serum levels of total bilirubin, aspartate aminotransferase and alanine aminotransferase. Histologically, zone III necrosis was found more frequently in patients with acute hepatitis than in those with chronic hepatitis. However, there was no difference in the frequency of cirrhosis between patients with and without zone III necrosis. In addition, normalization of serum alanine aminotransferase levels within six months after the introduction of corticosteroid treatment was slightly more frequent in patients with zone III necrosis (95% vs. 88%). Conclusion: In Japanese patients, zone III necrosis may reflect not only acute autoimmune hepatitis, but also acute exacerbation of pre-existing chronic disease. Furthermore, patients with zone III necrosis may respond better to corticosteroid treatment than those without.

Original languageEnglish
Pages (from-to)801-805
Number of pages5
JournalHepatology Research
Volume37
Issue number10
DOIs
Publication statusPublished - Oct 2007

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Autoimmune Hepatitis
Necrosis
North America
Alanine Transaminase
Adrenal Cortex Hormones
Fibrosis
Preexisting Condition Coverage
Acute Disease
Chronic Hepatitis
HLA Antigens
Aspartate Aminotransferases
Serum
Bilirubin
Serum Albumin
Hepatitis
Chronic Disease

Keywords

  • Acute hepatitis
  • Autoimmune hepatitis
  • Cirrhosis
  • Zone III necrosis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Clinical features of Japanese type 1 autoimmune hepatitis patients with zone III necrosis. / Miyake, Yasuhiro; Iwasaki, Yoshiaki; Terada, Ryo; Onishi, Toru; Okamoto, Ryoichi; Takaguchi, Kouichi; Ikeda, Hiroshi; Makino, Yasuhiro; Kobashi, Haruhiko; Sakaguchi, Kohsaku; Shiratori, Yasushi.

In: Hepatology Research, Vol. 37, No. 10, 10.2007, p. 801-805.

Research output: Contribution to journalArticle

Miyake, Y, Iwasaki, Y, Terada, R, Onishi, T, Okamoto, R, Takaguchi, K, Ikeda, H, Makino, Y, Kobashi, H, Sakaguchi, K & Shiratori, Y 2007, 'Clinical features of Japanese type 1 autoimmune hepatitis patients with zone III necrosis', Hepatology Research, vol. 37, no. 10, pp. 801-805. https://doi.org/10.1111/j.1872-034X.2007.00125.x
Miyake, Yasuhiro ; Iwasaki, Yoshiaki ; Terada, Ryo ; Onishi, Toru ; Okamoto, Ryoichi ; Takaguchi, Kouichi ; Ikeda, Hiroshi ; Makino, Yasuhiro ; Kobashi, Haruhiko ; Sakaguchi, Kohsaku ; Shiratori, Yasushi. / Clinical features of Japanese type 1 autoimmune hepatitis patients with zone III necrosis. In: Hepatology Research. 2007 ; Vol. 37, No. 10. pp. 801-805.
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AU - Miyake, Yasuhiro

AU - Iwasaki, Yoshiaki

AU - Terada, Ryo

AU - Onishi, Toru

AU - Okamoto, Ryoichi

AU - Takaguchi, Kouichi

AU - Ikeda, Hiroshi

AU - Makino, Yasuhiro

AU - Kobashi, Haruhiko

AU - Sakaguchi, Kohsaku

AU - Shiratori, Yasushi

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N2 - Aim: In Caucasians in northern Europe and North America, type 1 autoimmune hepatitis is characterized by susceptibility to human leukocyte antigens DR3 and DR4, and patients with zone III necrosis more frequently have an acute onset of the disease and a lower frequency of cirrhosis than those without. In Japanese patients, however, type 1 autoimmune hepatitis is primarily associated with DR4, and there are almost no DR3-positive patients. Thus, the clinical features of Japanese patients with type 1 autoimmune hepatitis and zone III necrosis may be different from those reported previously for Caucasians. Methods: We investigated 160 consecutive patients with type 1 autoimmune hepatitis (20 males and 140 females; median age, 55 years; range, 16-79 years). Results: Forty-seven patients (29%) had zone III necrosis, and these patients had lower serum levels of albumin and higher serum levels of total bilirubin, aspartate aminotransferase and alanine aminotransferase. Histologically, zone III necrosis was found more frequently in patients with acute hepatitis than in those with chronic hepatitis. However, there was no difference in the frequency of cirrhosis between patients with and without zone III necrosis. In addition, normalization of serum alanine aminotransferase levels within six months after the introduction of corticosteroid treatment was slightly more frequent in patients with zone III necrosis (95% vs. 88%). Conclusion: In Japanese patients, zone III necrosis may reflect not only acute autoimmune hepatitis, but also acute exacerbation of pre-existing chronic disease. Furthermore, patients with zone III necrosis may respond better to corticosteroid treatment than those without.

AB - Aim: In Caucasians in northern Europe and North America, type 1 autoimmune hepatitis is characterized by susceptibility to human leukocyte antigens DR3 and DR4, and patients with zone III necrosis more frequently have an acute onset of the disease and a lower frequency of cirrhosis than those without. In Japanese patients, however, type 1 autoimmune hepatitis is primarily associated with DR4, and there are almost no DR3-positive patients. Thus, the clinical features of Japanese patients with type 1 autoimmune hepatitis and zone III necrosis may be different from those reported previously for Caucasians. Methods: We investigated 160 consecutive patients with type 1 autoimmune hepatitis (20 males and 140 females; median age, 55 years; range, 16-79 years). Results: Forty-seven patients (29%) had zone III necrosis, and these patients had lower serum levels of albumin and higher serum levels of total bilirubin, aspartate aminotransferase and alanine aminotransferase. Histologically, zone III necrosis was found more frequently in patients with acute hepatitis than in those with chronic hepatitis. However, there was no difference in the frequency of cirrhosis between patients with and without zone III necrosis. In addition, normalization of serum alanine aminotransferase levels within six months after the introduction of corticosteroid treatment was slightly more frequent in patients with zone III necrosis (95% vs. 88%). Conclusion: In Japanese patients, zone III necrosis may reflect not only acute autoimmune hepatitis, but also acute exacerbation of pre-existing chronic disease. Furthermore, patients with zone III necrosis may respond better to corticosteroid treatment than those without.

KW - Acute hepatitis

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