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. 2018 Mar 30;2(2):54-58.
doi: 10.1002/jgh3.12046. eCollection 2018 Apr.

Non-alcoholic fatty liver disease in patients with autoimmune hepatitis

Atsushi Takahashi  1 , Teruko Arinaga-Hino  2 , Hiromasa Ohira  1 , Kazumichi Abe  1 , Takuji Torimura  2 , Mikio Zeniya  3 , Masanori Abe  4 , Kaname Yoshizawa  5 , Akinobu Takaki  6 , Yoshiyuki Suzuki  7 , Jong-Hon Kang  8 , Nobuhiro Nakamoto  9 , Tomoo Fujisawa  10 , Atsushi Tanaka  11 , Hajime Takikawa  11 ; Japan AIH Study Group (JAIHSG)
Affiliations

Non-alcoholic fatty liver disease in patients with autoimmune hepatitis

Atsushi Takahashi et al. JGH Open. .

Abstract

Background and aim: The incidence of non-alcoholic fatty liver disease (NAFLD) is increasing all over the world. NAFLD develops in patients with liver disease, including patients with autoimmune hepatitis (AIH). NAFLD and AIH have some similar laboratory and histological findings. The aim of this study was to elucidate the characteristics of AIH patients with NAFLD.

Methods: We re-evaluated the nationwide survey performed in Japan in 2015 of AIH patients diagnosed between 2009 and 2013.

Results: A total of 1151 subjects (144 men and 1007 women) were enrolled in the present study. The overall prevalence of NAFLD was 17.0%. Compared to AIH without NAFLD, AIH patients with NAFLD had the following characteristics: (i) low female-to-male ratio, (ii) older age, (iii) mild elevation in hepatobiliary enzymes, (iv) histologically progressive fibrosis and mild plasma cell infiltration or mild lobular hepatitis, (v) lower prevalence of prednisolone administration and higher prevalence of ursodeoxycholic acid administration, (vi) higher levels of hepatic enzymes and immunoglobulin G after treatment, and (vii) similar prevalence of autoimmune and malignant complications.

Conclusion: AIH patients with NAFLD have many features that are different from AIH patients without NAFLD. Understanding these differences is essential for the proper diagnosis and treatment of AIH patients with NAFLD.

Keywords: autoimmune hepatitis; laboratory findings; liver histological findings; nationwide survey; non‐alcoholic fatty liver disease; treatment.

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