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

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26 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
Externally publishedYes

Keywords

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

ASJC Scopus subject areas

  • Hepatology
  • Infectious Diseases

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    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, 37(10), 801-805. https://doi.org/10.1111/j.1872-034X.2007.00125.x