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. 2021 Mar;54(1):8-13.
doi: 10.1007/s00795-020-00255-5. Epub 2020 May 15.

Differences in autoimmune hepatitis based on inflammation localization

Atsushi Takahashi  1 , Hiromasa Ohira  2 , Kazumichi Abe  2 , Mikio Zeniya  3 , Masanori Abe  4 , Teruko Arinaga-Hino  5 , Takuji Torimura  5 , Kaname Yoshizawa  6 , Akinobu Takaki  7 , Jong-Hon Kang  8 , Yoshiyuki Suzuki  9 , Nobuhiro Nakamoto  10 , Ayano Inui  11 , Atsushi Tanaka  12 , Hajime Takikawa  13
Affiliations

Differences in autoimmune hepatitis based on inflammation localization

Atsushi Takahashi et al. Med Mol Morphol. 2021 Mar.

Abstract

Histopathology is essential for the diagnosis and evaluation of disease activity of autoimmune hepatitis (AIH). We aimed to elucidate the characteristics of AIH from the localization of inflammation. We re-evaluated a nationwide survey that was performed in Japan in 2018 of AIH patients diagnosed between 2014 and 2017. A total of 303 patients were enrolled, and the clinical and treatment characteristics were compared between the patients with predominantly portal inflammation (230 patients) or lobular inflammation (73 patients). AIH patients with lobular inflammation had a higher probability of being diagnosed with acute hepatitis than those with portal inflammation. Liver enzyme levels were higher in patients with lobular inflammation, whereas immunoglobulin G levels were higher in patients with portal inflammation. The prevalence of an alanine aminotransferase level < 30 U/L after 6 months of treatment was significantly higher in patients with lobular inflammation than in those with portal inflammation (81.7% vs. 67.3%, P = 0.046). The localization of inflammation may be useful for evaluating the onset of AIH.

Keywords: Acute hepatitis; Autoimmune hepatitis; Lobular inflammation; Portal inflammation; Treatment.

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