Evaluation of risk factors for the development of cirrhosis in autoimmune hepatitis: Japanese NHO-AIH prospective study
Autoimmune hepatitis (AIH) is a chronic and progressive liver disease characterized by histological interface hepatitis and circulating autoantibodies. Our aims were to evaluate risk factors that contribute to the outcome and, particularly, the development of liver cirrhosis in a prospective multice...
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| Veröffentlicht in: | Journal of gastroenterology 2011-01, Vol.46 (1), p.56-62 |
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| creator | Migita, Kiyoshi Watanabe, Yukio Jiuchi, Yuka Nakamura, Yoko Saito, Akira Yagura, Michiyasu Morimoto, Hideo Shimada, Masaaki Mita, Eiji Hijioka, Taizo Yamashita, Haruhiro Takezaki, Eiichi Muro, Toyokichi Sakai, Hironori Nakamuta, Makoto Abiru, Seigo Yano, Koji Komori, Atsumasa Yatsuhashi, Hiroshi Nakamura, Minoru Ishibashi, Hiromi |
| description | Autoimmune hepatitis (AIH) is a chronic and progressive liver disease characterized by histological interface hepatitis and circulating autoantibodies. Our aims were to evaluate risk factors that contribute to the outcome and, particularly, the development of liver cirrhosis in a prospective multicenter cohort study of AIH. One hundred and seventy-four patients were enrolled. Histologically 21 (12.1%) had cirrhosis at the initial observation and the remaining 153 showed chronic or acute hepatitis at presentation. Among the latter 153 patients, 14 developed cirrhosis during the follow-up period (mean 8.0 years). Demographic, clinical, and laboratory indices associated with the development of cirrhosis were identified. Patients who developed cirrhosis differed in mean levels of alanine aminotransferase (ALT; 158 ± 182 vs. 441 ± 423 IU/ml) and platelet counts (14.7 ± 5.5 vs. 19.4 ± 6.9 × 10⁴/μl) at presentation and received lower doses of corticosteroid (13.9 ± 15.8 vs. 31.8 ± 85.5 mg/day). In a multivariate analysis, an independent predictor for progression to cirrhosis was an older age of onset (≥60 years). AIH patients with cirrhosis, or those who developed cirrhosis, had a worse survival. AIH patients with an older age of onset were likely to develop cirrhosis, and careful observation and aggressive treatments are necessary for such patients. |
| doi_str_mv | 10.1007/s00535-010-0337-y |
| format | Article |
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Our aims were to evaluate risk factors that contribute to the outcome and, particularly, the development of liver cirrhosis in a prospective multicenter cohort study of AIH. One hundred and seventy-four patients were enrolled. Histologically 21 (12.1%) had cirrhosis at the initial observation and the remaining 153 showed chronic or acute hepatitis at presentation. Among the latter 153 patients, 14 developed cirrhosis during the follow-up period (mean 8.0 years). Demographic, clinical, and laboratory indices associated with the development of cirrhosis were identified. Patients who developed cirrhosis differed in mean levels of alanine aminotransferase (ALT; 158 ± 182 vs. 441 ± 423 IU/ml) and platelet counts (14.7 ± 5.5 vs. 19.4 ± 6.9 × 10⁴/μl) at presentation and received lower doses of corticosteroid (13.9 ± 15.8 vs. 31.8 ± 85.5 mg/day). In a multivariate analysis, an independent predictor for progression to cirrhosis was an older age of onset (≥60 years). AIH patients with cirrhosis, or those who developed cirrhosis, had a worse survival. AIH patients with an older age of onset were likely to develop cirrhosis, and careful observation and aggressive treatments are necessary for such patients.</description><identifier>ISSN: 0944-1174</identifier><identifier>EISSN: 1435-5922</identifier><identifier>DOI: 10.1007/s00535-010-0337-y</identifier><identifier>PMID: 21042923</identifier><language>eng</language><publisher>Japan: Japan : Springer Japan</publisher><subject>Abdominal Surgery ; Adolescent ; Adult ; Age Factors ; Age of Onset ; Aged ; Aged, 80 and over ; Alanine Transaminase - metabolism ; Autoantibodies ; Autoantibodies - immunology ; Autoimmune hepatitis ; Autoimmunity ; Chronic active hepatitis ; Cohort Studies ; Colorectal Surgery ; Disease Progression ; Dose-Response Relationship, Drug ; Female ; Follow-Up Studies ; Gastroenterology ; Glucocorticoids - administration & dosage ; Glucocorticoids - therapeutic use ; Hepatitis, Autoimmune - complications ; Hepatitis, Autoimmune - drug therapy ; Hepatitis, Autoimmune - immunology ; Hepatology ; Humans ; International Forum ; Japan - epidemiology ; Liver ; Liver cirrhosis ; Liver Cirrhosis - epidemiology ; Liver Cirrhosis - etiology ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multicenter cohort study ; Multivariate Analysis ; Outcome ; Platelet Count ; Prospective Studies ; Risk Factors ; Surgical Oncology ; Survival ; Young Adult</subject><ispartof>Journal of gastroenterology, 2011-01, Vol.46 (1), p.56-62</ispartof><rights>Springer 2010</rights><rights>COPYRIGHT 2011 Springer</rights><rights>Springer 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c588t-56aaedce83c4e821ed8f0648adb8b8033b8bcc54cb4f3a757efea07327dbf04e3</citedby><cites>FETCH-LOGICAL-c588t-56aaedce83c4e821ed8f0648adb8b8033b8bcc54cb4f3a757efea07327dbf04e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00535-010-0337-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00535-010-0337-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21042923$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Migita, Kiyoshi</creatorcontrib><creatorcontrib>Watanabe, Yukio</creatorcontrib><creatorcontrib>Jiuchi, Yuka</creatorcontrib><creatorcontrib>Nakamura, Yoko</creatorcontrib><creatorcontrib>Saito, Akira</creatorcontrib><creatorcontrib>Yagura, Michiyasu</creatorcontrib><creatorcontrib>Morimoto, Hideo</creatorcontrib><creatorcontrib>Shimada, Masaaki</creatorcontrib><creatorcontrib>Mita, Eiji</creatorcontrib><creatorcontrib>Hijioka, Taizo</creatorcontrib><creatorcontrib>Yamashita, Haruhiro</creatorcontrib><creatorcontrib>Takezaki, Eiichi</creatorcontrib><creatorcontrib>Muro, Toyokichi</creatorcontrib><creatorcontrib>Sakai, Hironori</creatorcontrib><creatorcontrib>Nakamuta, Makoto</creatorcontrib><creatorcontrib>Abiru, Seigo</creatorcontrib><creatorcontrib>Yano, Koji</creatorcontrib><creatorcontrib>Komori, Atsumasa</creatorcontrib><creatorcontrib>Yatsuhashi, Hiroshi</creatorcontrib><creatorcontrib>Nakamura, Minoru</creatorcontrib><creatorcontrib>Ishibashi, Hiromi</creatorcontrib><title>Evaluation of risk factors for the development of cirrhosis in autoimmune hepatitis: Japanese NHO-AIH prospective study</title><title>Journal of gastroenterology</title><addtitle>J Gastroenterol</addtitle><addtitle>J Gastroenterol</addtitle><description>Autoimmune hepatitis (AIH) is a chronic and progressive liver disease characterized by histological interface hepatitis and circulating autoantibodies. Our aims were to evaluate risk factors that contribute to the outcome and, particularly, the development of liver cirrhosis in a prospective multicenter cohort study of AIH. One hundred and seventy-four patients were enrolled. Histologically 21 (12.1%) had cirrhosis at the initial observation and the remaining 153 showed chronic or acute hepatitis at presentation. Among the latter 153 patients, 14 developed cirrhosis during the follow-up period (mean 8.0 years). Demographic, clinical, and laboratory indices associated with the development of cirrhosis were identified. Patients who developed cirrhosis differed in mean levels of alanine aminotransferase (ALT; 158 ± 182 vs. 441 ± 423 IU/ml) and platelet counts (14.7 ± 5.5 vs. 19.4 ± 6.9 × 10⁴/μl) at presentation and received lower doses of corticosteroid (13.9 ± 15.8 vs. 31.8 ± 85.5 mg/day). In a multivariate analysis, an independent predictor for progression to cirrhosis was an older age of onset (≥60 years). AIH patients with cirrhosis, or those who developed cirrhosis, had a worse survival. AIH patients with an older age of onset were likely to develop cirrhosis, and careful observation and aggressive treatments are necessary for such patients.</description><subject>Abdominal Surgery</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Age of Onset</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alanine Transaminase - metabolism</subject><subject>Autoantibodies</subject><subject>Autoantibodies - immunology</subject><subject>Autoimmune hepatitis</subject><subject>Autoimmunity</subject><subject>Chronic active hepatitis</subject><subject>Cohort Studies</subject><subject>Colorectal Surgery</subject><subject>Disease Progression</subject><subject>Dose-Response Relationship, Drug</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology</subject><subject>Glucocorticoids - administration & dosage</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Hepatitis, Autoimmune - complications</subject><subject>Hepatitis, Autoimmune - drug therapy</subject><subject>Hepatitis, Autoimmune - immunology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>International Forum</subject><subject>Japan - epidemiology</subject><subject>Liver</subject><subject>Liver cirrhosis</subject><subject>Liver Cirrhosis - epidemiology</subject><subject>Liver Cirrhosis - etiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multicenter cohort study</subject><subject>Multivariate Analysis</subject><subject>Outcome</subject><subject>Platelet Count</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Surgical Oncology</subject><subject>Survival</subject><subject>Young 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Yoko ; Saito, Akira ; Yagura, Michiyasu ; Morimoto, Hideo ; Shimada, Masaaki ; Mita, Eiji ; Hijioka, Taizo ; Yamashita, Haruhiro ; Takezaki, Eiichi ; Muro, Toyokichi ; Sakai, Hironori ; Nakamuta, Makoto ; Abiru, Seigo ; Yano, Koji ; Komori, Atsumasa ; Yatsuhashi, Hiroshi ; Nakamura, Minoru ; Ishibashi, Hiromi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c588t-56aaedce83c4e821ed8f0648adb8b8033b8bcc54cb4f3a757efea07327dbf04e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Abdominal Surgery</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Age of Onset</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alanine Transaminase - metabolism</topic><topic>Autoantibodies</topic><topic>Autoantibodies - immunology</topic><topic>Autoimmune hepatitis</topic><topic>Autoimmunity</topic><topic>Chronic active 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of risk factors for the development of cirrhosis in autoimmune hepatitis: Japanese NHO-AIH prospective study</atitle><jtitle>Journal of gastroenterology</jtitle><stitle>J Gastroenterol</stitle><addtitle>J Gastroenterol</addtitle><date>2011-01-01</date><risdate>2011</risdate><volume>46</volume><issue>1</issue><spage>56</spage><epage>62</epage><pages>56-62</pages><issn>0944-1174</issn><eissn>1435-5922</eissn><abstract>Autoimmune hepatitis (AIH) is a chronic and progressive liver disease characterized by histological interface hepatitis and circulating autoantibodies. Our aims were to evaluate risk factors that contribute to the outcome and, particularly, the development of liver cirrhosis in a prospective multicenter cohort study of AIH. One hundred and seventy-four patients were enrolled. Histologically 21 (12.1%) had cirrhosis at the initial observation and the remaining 153 showed chronic or acute hepatitis at presentation. Among the latter 153 patients, 14 developed cirrhosis during the follow-up period (mean 8.0 years). Demographic, clinical, and laboratory indices associated with the development of cirrhosis were identified. Patients who developed cirrhosis differed in mean levels of alanine aminotransferase (ALT; 158 ± 182 vs. 441 ± 423 IU/ml) and platelet counts (14.7 ± 5.5 vs. 19.4 ± 6.9 × 10⁴/μl) at presentation and received lower doses of corticosteroid (13.9 ± 15.8 vs. 31.8 ± 85.5 mg/day). In a multivariate analysis, an independent predictor for progression to cirrhosis was an older age of onset (≥60 years). AIH patients with cirrhosis, or those who developed cirrhosis, had a worse survival. AIH patients with an older age of onset were likely to develop cirrhosis, and careful observation and aggressive treatments are necessary for such patients.</abstract><cop>Japan</cop><pub>Japan : Springer Japan</pub><pmid>21042923</pmid><doi>10.1007/s00535-010-0337-y</doi><tpages>7</tpages></addata></record> |
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| subjects | Abdominal Surgery Adolescent Adult Age Factors Age of Onset Aged Aged, 80 and over Alanine Transaminase - metabolism Autoantibodies Autoantibodies - immunology Autoimmune hepatitis Autoimmunity Chronic active hepatitis Cohort Studies Colorectal Surgery Disease Progression Dose-Response Relationship, Drug Female Follow-Up Studies Gastroenterology Glucocorticoids - administration & dosage Glucocorticoids - therapeutic use Hepatitis, Autoimmune - complications Hepatitis, Autoimmune - drug therapy Hepatitis, Autoimmune - immunology Hepatology Humans International Forum Japan - epidemiology Liver Liver cirrhosis Liver Cirrhosis - epidemiology Liver Cirrhosis - etiology Male Medicine Medicine & Public Health Middle Aged Multicenter cohort study Multivariate Analysis Outcome Platelet Count Prospective Studies Risk Factors Surgical Oncology Survival Young Adult |
| title | Evaluation of risk factors for the development of cirrhosis in autoimmune hepatitis: Japanese NHO-AIH prospective study |
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