A Case of Severe Autoimmune Hepatitis that was Treated Successfully with Steroid Therapy

A 56-year-old woman was admitted to our hospital due to liver dysfunction with epigastralgia and jaundice. Her laboratory data showed AST: 731 IU/L, ALT: 839 IU/L, T-B: 7.0 mg/dl, PT: 57%, ANA: ·640, and IgG: 1444 mg/dl. Liver biopsy findings and laboratory data were consistent with severe autoimmun...

Full description

Saved in:
Bibliographic Details
Published inJournal of Nihon University Medical Association Vol. 77; no. 1; pp. 45 - 50
Main Authors Arima, Shuhei, Fujikawa, Hirotoshi, Endo, Takako, Ouchi, Kotoyo, Masuda, Ai, Fujii, Tetsuro, Tsutsumi, Natsuko, Uno, Akitake, Tsujimura, Ryusuke, Nemoto, Norimichi, Miura, Takao, Matsuok, Shunichi, Moriyama, Mitsuhiko
Format Journal Article
LanguageJapanese
Published NIHON UNIVERSITY MEDICAL ASSOCIATION 01.02.2018
Subjects
autoimmune hepatitis
severe autoimmune hepatitis with acute presentation
Online AccessGet full text

Cover

Abstract A 56-year-old woman was admitted to our hospital due to liver dysfunction with epigastralgia and jaundice. Her laboratory data showed AST: 731 IU/L, ALT: 839 IU/L, T-B: 7.0 mg/dl, PT: 57%, ANA: ·640, and IgG: 1444 mg/dl. Liver biopsy findings and laboratory data were consistent with severe autoimmune hepatitis with acute presentation. Therefore, we started steroid therapy from the 8th hospital day, and she exhibited a benign course. Severe autoimmune hepatitis with acute presentation may develop into a more severe course and liver failure in the absence of treatment. If clinically autoimmune hepatitis is suspected, liver biopsy and initiation of steroid therapy as soon as possible are important in determining the convalescence of the patient.
AbstractList A 56-year-old woman was admitted to our hospital due to liver dysfunction with epigastralgia and jaundice. Her laboratory data showed AST: 731 IU/L, ALT: 839 IU/L, T-B: 7.0 mg/dl, PT: 57%, ANA: ·640, and IgG: 1444 mg/dl. Liver biopsy findings and laboratory data were consistent with severe autoimmune hepatitis with acute presentation. Therefore, we started steroid therapy from the 8th hospital day, and she exhibited a benign course. Severe autoimmune hepatitis with acute presentation may develop into a more severe course and liver failure in the absence of treatment. If clinically autoimmune hepatitis is suspected, liver biopsy and initiation of steroid therapy as soon as possible are important in determining the convalescence of the patient.
Author Nemoto, Norimichi
Arima, Shuhei
Miura, Takao
Ouchi, Kotoyo
Moriyama, Mitsuhiko
Endo, Takako
Tsutsumi, Natsuko
Uno, Akitake
Masuda, Ai
Fujikawa, Hirotoshi
Fujii, Tetsuro
Matsuok, Shunichi
Tsujimura, Ryusuke
Author_xml – sequence: 1
  fullname: Arima, Shuhei
  organization: Department of Gastroenterology and Hepatology, Japan Community Health care Organization Yokohama Central Hospital
– sequence: 2
  fullname: Fujikawa, Hirotoshi
  organization: Department of Gastroenterology and Hepatology, Japan Community Health care Organization Yokohama Central Hospital
– sequence: 3
  fullname: Endo, Takako
  organization: Department of Gastroenterology and Hepatology, Japan Community Health care Organization Yokohama Central Hospital
– sequence: 4
  fullname: Ouchi, Kotoyo
  organization: Department of Gastroenterology and Hepatology, Japan Community Health care Organization Yokohama Central Hospital
– sequence: 5
  fullname: Masuda, Ai
  organization: Department of Gastroenterology and Hepatology, Japan Community Health care Organization Yokohama Central Hospital
– sequence: 6
  fullname: Fujii, Tetsuro
  organization: Department of Gastroenterology and Hepatology, Japan Community Health care Organization Yokohama Central Hospital
– sequence: 7
  fullname: Tsutsumi, Natsuko
  organization: Department of Gastroenterology and Hepatology, Japan Community Health care Organization Yokohama Central Hospital
– sequence: 8
  fullname: Uno, Akitake
  organization: Endoscopy Center, Japan Community Health care Organization Yokohama Central Hospital
– sequence: 9
  fullname: Tsujimura, Ryusuke
  organization: Division of Morphological and Functional Pathology, Department of pathology and Microbiology, Nihon University School of Medicine
– sequence: 10
  fullname: Nemoto, Norimichi
  organization: Division of Morphological and Functional Pathology, Department of pathology and Microbiology, Nihon University School of Medicine
– sequence: 11
  fullname: Miura, Takao
  organization: Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine
– sequence: 12
  fullname: Matsuok, Shunichi
  organization: Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine
– sequence: 13
  fullname: Moriyama, Mitsuhiko
  organization: Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine
BookMark eNo9kL1OwzAYRS1UJErpxgP4BRLs2I7jgaGqgCJVYmgGNstxPhNX-alsh6pvjyoQyz3SGc5w79FinEZA6JGSnBclfxrnweRS5lRzcYOWtKp4RqRUC7QkpFAZ4QW_Q-sYfUMIFUxUSi3R5wZvTQQ8OXyAbwiAN3Oa_DDMI-AdnEzyyUecOpPw2URcBzAJWnyYrYUY3dz3F3z2qcOHBGHyLa47COZ0eUC3zvQR1n9cofr1pd7usv3H2_t2s8-OqhCZKoGXtJKmqRxX1opClIJJ1jaulUApqIYXrOHAlARGLVekMq20FXDHQDq2Qs-_2WNM5gv0KfjBhIs2IXnbg76-oqXU9Dpc_HvbmaBhZD9eTmEh
ContentType Journal Article
Copyright 2018 The Nihon University Medical Association
Copyright_xml – notice: 2018 The Nihon University Medical Association
DOI 10.4264/numa.77.1_45
DatabaseTitleList
DeliveryMethod fulltext_linktorsrc
EISSN 1884-0779
EndPage 50
ExternalDocumentID article_numa_77_1_77_45_article_char_en
GroupedDBID 5GY
ALMA_UNASSIGNED_HOLDINGS
F5P
JSF
RJT
ID FETCH-LOGICAL-j925-96e46187ab8f49cc52565373dbfd7e11e9b423b4e397e31c4908ad7c8e4f3e7f3
ISSN 0029-0424
IngestDate Wed Apr 05 13:22:26 EDT 2023
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Issue 1
Language Japanese
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-j925-96e46187ab8f49cc52565373dbfd7e11e9b423b4e397e31c4908ad7c8e4f3e7f3
OpenAccessLink https://www.jstage.jst.go.jp/article/numa/77/1/77_45/_article/-char/en
PageCount 6
ParticipantIDs jstage_primary_article_numa_77_1_77_45_article_char_en
PublicationCentury 2000
PublicationDate 2018/02/01
PublicationDateYYYYMMDD 2018-02-01
PublicationDate_xml – month: 02
  year: 2018
  text: 2018/02/01
  day: 01
PublicationDecade 2010
PublicationTitle Journal of Nihon University Medical Association
PublicationTitleAlternate Journal of Nihon University Medical Association
PublicationYear 2018
Publisher NIHON UNIVERSITY MEDICAL ASSOCIATION
Publisher_xml – name: NIHON UNIVERSITY MEDICAL ASSOCIATION
References 8) Björnsson E, Talwalkar J, Treeprasertsuk S, et al. Drug-induced autoimmune hepatitis. clinical characteristics and prognosis. Hepatology 2010; 51(6): 2040-2048.
10) Vento S, Cainelli F. Is there a role for viruses in triggering autoimmune hepatitis. Autoimmun Rev 2004; (1): 61-69.
6) 厚生労働省「難治性の肝 胆道疾患に関する調査研究」班編．「自己免疫性肝炎 (AIH) の診療ガイド」．文光堂，東京，2011.
5) 滝川　一，恩池森一，高森頼雪，他．DDW-J 2004 ワークショップ薬剤性肝障害診断基準の提案．肝臓2005.
13) Fisher K, Vuppalanchi R, Saxena R. Drug-Induced Liver Injury. Arch Pathol Lab Med 2015; 139(7): 876-887.
12) Yoshizawa K, Ota M, Katsuyama Y, et al. Genetic analysis of the HLA region of Japanese patients with type 1 autoimmune hepatitis. Journal of Hepatology 2005; 42(4): 578-584.
17) Mukhtar RY, Reid J, Reckless JP. Pitavastatin. Int J Clin Pract 2005; 59(2): 239-252.
11) 宮川　浩，菊池健太郎．自己免疫性肝炎の標的抗原と自己抗体．肝胆膵 2009; (59): 27-34.
2) Czaja AJ, Manns MP. Advances in the diagnosis, pathogenesis, and management of autoimmune hepatitis. Gastroenterology 2010; 139(1): 58-72.
4) Hennes EM, Zeniya M, Czaja AJ, et al. International Autoimmune Hepatitis Group. Simplified criteria for the diagnosis of autoimmune hepatitis. Hepatology 2008; 48(1): 169-176.
15) Takahashi H, Zeniya M. Acute presentation of autoimmune hepatitis. Does it exist? A published work review. Hepatol Res 2011; (41): 498-504.
14) Miyake Y, Iwasaki Y, Kobayashi H, et al. Autoimmune hepatitis with acute presentation in Japan. Dig Liver Dis 2010; (42): 51-54.
3) Alvarez F, Berg PA, Bianchi FB, et al. International Autoimmune Hepatitis Group. Report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol 1999; 31(5): 929-938.
9) Alla V, Abraham J, Siddiqui J, Raina D, Wu GY, Chalasani NP, Bonkovsky HL. Autoimmune hepatitis triggered by statins. J Clin Gastroenterology 2006 Sep; 40(8): 757-761.
7) Waldenström J. Leber, Blutproteine und Nahrungseiweiss. Dtsch Ges Verdau Stoffwechselkr. 1950; 15: 113-119.
1) Mackay IR, Weiden S, Hasker J. Autoimmune hepatitis. Ann N Y Acad Sci 1965 Jun 30; 124(2): 767-780.
16) 藤川博敏，宮川　浩，長谷川博雅，他．当院における急性発症型の自己免疫性肝炎の臨床病理像と治療，予後について．肝臓 2014; (55): 195.
References_xml
SSID ssib001535899
ssib007484389
ssj0000389138
ssib004298531
ssib031782894
ssib004001855
ssib041932707
Score 2.146724
Snippet A 56-year-old woman was admitted to our hospital due to liver dysfunction with epigastralgia and jaundice. Her laboratory data showed AST: 731 IU/L, ALT: 839...
SourceID jstage
SourceType Publisher
StartPage 45
SubjectTerms autoimmune hepatitis
severe autoimmune hepatitis with acute presentation
Title A Case of Severe Autoimmune Hepatitis that was Treated Successfully with Steroid Therapy
URI https://www.jstage.jst.go.jp/article/numa/77/1/77_45/_article/-char/en
Volume 77
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
ispartofPNX Journal of Nihon University Medical Association, 2018/02/01, Vol.77(1), pp.45-50
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lj9MwELbKcuGCQIB4ywduVUq9tuPkWK2KWhBF0CCVU-QkjppW26BtotXy6_hpzNh57cJh2YtVJXEVe76MP4_nQci7TGYZC8IUvm8hPaET5mkpc88P0tQI7WecY6Dw55W_-C4-buRmNPo98Fqqq2SS_vpnXMldpArXQK4YJfsfku3-FC7Ab5AvtCBhaG8l49n4TDtb_NrAy5vxrK7KAiM-DKwn6CtdFUeglroaX-rjOEKCiASztlUS0fJ-5Qyxa5jdssjQ_6LLMfA3Y10VW8DKwJWjPeW5KWMLoOLc8tL1tt6aooNJvSv2-tLeWRQXZVUet93N-SGzhttI7_W-7My_WK7F6iN4-qocmilY0Ho2t14cy8WXld3Tzr-tl9GP69krl709ro0xwCMbF109MU41B4HwpsqVnml1d1MCZohRp4hdjspmSXepbW8uFsgFMflsfa4nSk1Y3Pa5ln67ES4WaNGxUjHDRsi4vY7BcYDFe-T-Kag61LGfvg7PIbkcnqsKLIIohxvYEPhSr2Exsyvv8_8DucMdcacxBdJt1WzYLdewx8xB68eEU-aiO3Bw74dDA4a1g_1G66to6VP0iDxsUERnbjyPyWinn5DNjCKAaZlTB2DaA5h2AKYIYAoApg2A6RDAFAFMGwDTBsBPSfRhHp0tvKbUh7cLT6UX-kb4LFA6CXIRpqkEIi654lmSZ8owZsIEaH8iDLBnw1mKp9U6U2lgRM6NyvkzcnIoD-Y5odrInCWJCaWExzKuFWfQOZTZdGpSHr4gvpuH-KdL5xLfUsIv79rxFXnQfxCvyUl1UZs3wGSr5K0Fyx_zF57F
link.rule.ids 315,783,787,27936,27937
linkProvider Colorado Alliance of Research Libraries
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=A+Case+of+Severe+Autoimmune+Hepatitis+that+was+Treated+Successfully+with+Steroid+Therapy&rft.jtitle=Journal+of+Nihon+University+Medical+Association&rft.au=Arima%2C+Shuhei&rft.au=Fujikawa%2C+Hirotoshi&rft.au=Endo%2C+Takako&rft.au=Ouchi%2C+Kotoyo&rft.date=2018-02-01&rft.pub=NIHON+UNIVERSITY+MEDICAL+ASSOCIATION&rft.issn=0029-0424&rft.eissn=1884-0779&rft.volume=77&rft.issue=1&rft.spage=45&rft.epage=50&rft_id=info:doi/10.4264%2Fnuma.77.1_45&rft.externalDocID=article_numa_77_1_77_45_article_char_en
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0029-0424&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0029-0424&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0029-0424&client=summon