. 2020 Aug 28;10(1):14250.

doi: 10.1038/s41598-020-71296-0.

Increasing incidence of acute autoimmune hepatitis: a nationwide survey in Japan

Affiliations

¹ Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan. junior@fmu.ac.jp.
² Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
³ Sanno Medical Center, International University of Health and Welfare, 8-10-16 Akasaka, Minato-ku, Tokyo, 107-0052, Japan.
⁴ Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, To-on, Ehime, 791-0295, Japan.
⁵ Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka, 830-0011, Japan.
⁶ Department of Gastroenterology, National Hospital Organization, Shinshu Ueda Medical Center, 1-27-21 Midorigaoka, Ueda-City, Nagano, 386-8610, Japan.
⁷ Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
⁸ Center for Gastroenterology, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan.
⁹ Department of Hepatology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
¹⁰ Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
¹¹ Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohamashi Tobu Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama City, Kanagawa, 230-0012, Japan.
¹² Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
¹³ Faculty of Medical Technology, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.

PMID: 32859968
PMCID: PMC7455563
DOI: 10.1038/s41598-020-71296-0

Increasing incidence of acute autoimmune hepatitis: a nationwide survey in Japan

Atsushi Takahashi et al. Sci Rep. 2020.

. 2020 Aug 28;10(1):14250.

doi: 10.1038/s41598-020-71296-0.

Authors

Affiliations

¹ Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan. junior@fmu.ac.jp.
² Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
³ Sanno Medical Center, International University of Health and Welfare, 8-10-16 Akasaka, Minato-ku, Tokyo, 107-0052, Japan.
⁴ Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, To-on, Ehime, 791-0295, Japan.
⁵ Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka, 830-0011, Japan.
⁶ Department of Gastroenterology, National Hospital Organization, Shinshu Ueda Medical Center, 1-27-21 Midorigaoka, Ueda-City, Nagano, 386-8610, Japan.
⁷ Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
⁸ Center for Gastroenterology, Teine Keijinkai Hospital, 1-12 Maeda, Teine-ku, Sapporo, 006-8555, Japan.
⁹ Department of Hepatology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
¹⁰ Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
¹¹ Department of Pediatric Hepatology and Gastroenterology, Saiseikai Yokohamashi Tobu Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama City, Kanagawa, 230-0012, Japan.
¹² Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
¹³ Faculty of Medical Technology, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.

PMID: 32859968
PMCID: PMC7455563
DOI: 10.1038/s41598-020-71296-0

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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Conflict of interest statement

Atsushi Tanaka received fees for promotional materials from Novartis Pharma. The others declare no competing interests.

Figures

**Figure 1**
Comparison between the 2015 survey (white bar) and the 2018 survey (black bar) in the distribution of serum (a) alanine aminotransferase (*ALT*) levels, (b) total bilirubin levels, (c) immunoglobulin G (*IgG*) levels, and (d) antinuclear antibody (*ANA*) titers at diagnosis in patients with autoimmune hepatitis.

**Figure 2**
Comparison between the 2015 survey (white bar) and the 2018 survey (black bar) in the distribution of the initial dosage of prednisolone.

See this image and copyright information in PMC

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Increasing incidence of acute autoimmune hepatitis: a nationwide survey in Japan

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Increasing incidence of acute autoimmune hepatitis: a nationwide survey in Japan

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