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Published on: May 29, 2020
Increasing incidence of acute autoimmune hepatitis: a nationwide survey in Japan
Atsushi Takahashi1, Hiromasa Ohira2, Kazumichi Abe2
1Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan. junior@fmu.ac.jp.
Insights
Trends in autoimmune hepatitis (AIH) show a significant increase in acute cases since 2014. Diagnosis and management of acute AIH are crucial, with evolving patient demographics and treatment patterns observed in Japan.
Area of Science:
- Hepatology
- Immunology
- Internal Medicine
Background:
- Japanese diagnostic guidelines for autoimmune hepatitis (AIH) were established in 2014.
- Previous surveys provide a baseline for comparison.
- Understanding current AIH trends is essential for clinical practice.
Purpose of the Study:
- To analyze trends and characteristics of AIH in Japan.
- To compare recent AIH cases with data from a prior survey.
- To identify changes in patient demographics, clinical features, and treatment.
Main Methods:
- A nationwide survey of 796 patients newly diagnosed with AIH between 2014 and 2017.
- Data collected from 54 hospitals across Japan.
- Comparison of clinical characteristics and treatment with a 2015 survey.
Main Results:
- The median age at diagnosis was 63 years, with a female to male ratio of 5.3:1.
- A significant increase in the incidence of AIH with histological acute hepatitis (from 11.0% to 21.7%).
- Changes in laboratory findings and prednisolone treatment correlated with the rise in acute AIH.
Conclusions:
- The clinical characteristics of AIH are rapidly evolving, particularly with an increasing incidence of acute AIH.
- Early elucidation and diagnosis of acute AIH are critical for effective patient management.
- These findings highlight the need for updated diagnostic and treatment strategies for AIH in Japan.
Abstract:
The Japanese diagnostic guidelines for autoimmune hepatitis (AIH) were proposed in 2014. This study aimed to determine the trends and characteristics of AIH based on a Japanese nationwide survey. Data for 796 patients who were newly diagnosed with AIH from 2014 to 2017 were collected from January to March, 2019 from 54 hospitals throughout Japan. Clinical characteristics, including treatment, were compared with those reported in a prior 2015 survey. The population had a median age of 63 years at diagnosis, and the male to female ratio was 1:5.3. The numbers of women was significantly lower in this survey than in the 2015 survey. Moreover, the incidence of AIH with histological acute hepatitis increased significantly from 11.0 to 21.7%. The changes in the laboratory findings, such as in transaminase and immunoglobulin G levels and antinuclear antibody titers, as well as in prednisolone treatment, reflected an increasing incidence of acute AIH. The clinical characteristics of AIH changed rapidly, in parallel with the increasing incidence of acute AIH. The elucidation and diagnosis of AIH with acute hepatitis are important in the management of AIH.
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