Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
Sanno Medical Center, International University of Health and Welfare, 8-10-16 Akasaka, Minato-ku, Tokyo, 107-0052, Japan.
Sci Rep. 2020 Aug 28;10(1):14250. doi: 10.1038/s41598-020-71296-0.
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.
日本自身免疫性肝炎（AIH）诊断指南于 2014 年提出。本研究旨在通过日本全国性调查，明确 AIH 的发病趋势和特点。2019 年 1 月至 3 月，从日本各地 54 家医院收集了 2014 年至 2017 年间新诊断为 AIH 的 796 例患者的数据。将这些患者的临床特征（包括治疗方法）与 2015 年的调查结果进行了比较。患者诊断时的中位年龄为 63 岁，男女比例为 1:5.3。与 2015 年的调查相比，女性患者的数量明显减少。此外，组织学表现为急性肝炎的 AIH 发病率从 11.0%显著上升至 21.7%。天门冬氨酸转氨酶和丙氨酸转氨酶、免疫球蛋白 G 水平和抗核抗体滴度等实验室检查结果以及泼尼松龙治疗的变化反映了急性 AIH 发病率的增加。AIH 的临床特征变化迅速，与急性 AIH 发病率的增加呈平行关系。阐明和诊断急性肝炎相关性 AIH 对于 AIH 的管理很重要。
