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Centrilobular necrosis in acute presentation of Japanese patients with type 1 autoimmune hepatitis

Kazumichi Abe1, Yukiko Kanno, Ken Okai

  • 1Kazumichi Abe, Yukiko Kanno, Ken Okai, Fumiko Katsushima, Kyoko Monoe, Hironobu Saito, Atsushi Takahashi, Junko Yokokawa, Hiromasa Ohira, Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan.

World Journal of Hepatology
|October 13, 2012
PubMed

Insights

Autoimmune hepatitis (AIH) with centrilobular necrosis (CN) presents differently than AIH without CN. AIH with CN shows lower IgG and higher antinuclear antibody-negative rates, suggesting a more acute presentation.

Area of Science:

  • Hepatology
  • Immunology
  • Pathology

Background:

  • Type 1 autoimmune hepatitis (AIH) is a chronic liver disease.
  • Acute presentations of AIH can be challenging to distinguish.
  • Centrilobular necrosis (CN) is a histological finding in liver injury.

Purpose of the Study:

  • To compare clinicopathological features of acute type 1 AIH with or without centrilobular necrosis (CN).
  • To identify distinguishing features between AIH with and without CN in acute presentations.

Main Methods:

  • Retrospective analysis of 41 patients with biopsy-proven acute type 1 AIH.
  • Comparison of clinicopathological data between AIH patients with and without CN.
  • Evaluation of patient background, clinical parameters, histology, and therapy.

Main Results:

  • Centrilobular necrosis (CN) was observed in 31.7% of acute AIH cases.
  • AIH with CN showed significantly lower serum IgG levels and higher antinuclear antibody-negative rates.
  • Patients with CN had a significantly lower frequency of advanced fibrosis (F3-4).

Conclusions:

  • Centrilobular necrosis (CN) occurs in both acute hepatitis and acute exacerbation phases of type 1 AIH.
  • AIH with CN often exhibits clinical features resembling the genuine acute form of the disease.
  • Histological findings like CN can help differentiate subtypes of acute AIH.
Abstract

Keywords:
Acute exacerbation phaseAcute hepatitis phaseAcute presentationAutoimmune hepatitisCentrilobular necrosis

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