Acute-onset Autoimmune Hepatitis Treated with Living Donor-liver Transplantation.

Kawai, Keiko; Michitaka, Kojiro; Miyauchi, Shozo; Sano, Masahiro; Abe, Masanori; Ninomiya, Tsuneyuki; Matsuura, Bunzo; Masumoto, T.; Akbar, Shahrazad; Horiike, Norio; Onji, Morikazu

doi:10.2169/internalmedicine.42.158

Cited by 7 publications

(7 citation statements)

References 17 publications

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“…3 The clinical features and prognosis of patients with fulminant-type autoimmune hepatitis have remained uncertain, and only a few adult cases have been reported, in detail. [4][5][6] Fulminant hepatic failure can progress rapidly to coma and death from cerebral oedema and multiple organ failure, and the only therapy of proven benefit is emergency liver transplantation. In the United States, 4% of cases with fulminant hepatic failure are due to autoimmune hepatitis, and the short-term transplantation-free survival rate of these patients is reported to be low.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of fulminant‐type autoimmune hepatitis: an analysis of eleven cases

Miyake

Iwasaki

Terada

et al. 2006

Aliment Pharmacol Ther

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Section: Introductionmentioning

confidence: 99%

Clinical characteristics of fulminant‐type autoimmune hepatitis: an analysis of eleven cases

Miyake

Iwasaki

Terada

et al. 2006

Aliment Pharmacol Ther

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“…We previously reported the clinical course from onset to just after LTx of this case [11] . The patient experienced episodes of transient mild acute rejection and a liver abscess at 3 mo and 1 year, respectively, following LTx, which were resolved by immunosuppression against the rejection and administration of antibiotics and discontinuation of prednisolone (PSL) for the liver abscess.…”

Section: Case Reportmentioning

confidence: 84%

Recurrence of autoimmune hepatitis after liver transplantation without elevation of alanine aminotransferase

Yao

Michitaka²,

Terada³

et al. 2007

WJG

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It is controversial whether steroid therapy should be continued to prevent the recurrence of autoimmune hepatitis (AIH) in patients who have undergone liver transplantation (LTx) due to AIH. We report a case of recurrent autoimmune hepatitis after LTx despite a persistently normal range of alanine aminotransferase (ALT). A 50-year-old woman was admitted to our hospital because of jaundice and severe liver dysfunction, where she was diagnosed with liver failure due to AIH. Steroid therapy was not effective enough and the patient received living-donor LTx in 1999. Following the operation, the level of ALT was maintained within a normal range and anti-nuclear antibody (ANA) became negative, however, the serum level of IgG gradually elevated and ANA became positive, while platelets decreased. A liver biopsy performed 6 years after LTx showed histological findings of AIH and she was diagnosed with recurrent AIH. A recurrence of AIH may occur after LTx even if the level of ALT remains within a normal range. We consider that a protocol liver biopsy should be performed in patients who undergo LTx due to AIH to decide the indication for steroid therapy.

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“…Liver transplantation is one of the therapeutic options for these patients with a fatal outcome. A case of severe acute hepatitis of AIH was also treated with liver transplantation, when corticosteroid therapy was not effective (11).…”

Section: Autoimmune Hepatitis (Aih) Presents As a Chronic Inflammatormentioning

confidence: 99%

Acute-Onset Autoimmune Hepatitis

Terada

Onji

2007

Intern. Med.

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F i g u r e 1 . Cl i n i c a l c o u r s e o f a c u t e -o n s e t a u t o i mmu n e h e p a t i t i s . A) T r u l y a c u t e -o n s e t AI H: L a b o r a t o r y d a t a ma y r ev e a l l o w t i t e r o f ANA a n d l o w I g G. P a t i e n t s h a v e s l i g h t s y mpt o ms a n d s h o w g o o d r e s p o n s e t o c o r t i c o s t e r o i d . B )Cl i n i c a l l y a c u t e -o n s e t AI H ( a c u t e e x a c e r b a t i o n o f AI H) : P a t i e n t s h a v e o f t e n s e v e r e c l i n i c a l ma n i f e s t a t i o n s . T h e y ma y h a v e r e s i st a n c e t o c o r t i c o s t e r o i d a n d o c c a s i o n a l l y r e a c h s e v e r e h e p a t it i s o r f u l mi n a n t h e p a t i t i s . Fig. 1 EDITORIAL Acute-Onset Autoimmune Hepatitis Lefkowitch et al first reported two AIH cases presenting histologically acute hepatitis (2). Burgart et al reported that only one of 26 recent-onset AIH patients showed lobular hepatitis without portal inflammation (3). In a Japanese nationwide survey study, 5.6% of patients with AIH were found to have a feature of acute hepatitis upon histological examination (4). The histological characteristics of acuteonset AIH revealed centrilobular necrosis, none or mild inflammatory infiltration in the portal area, and no portal fibrosis (5, 6). The serum gammaglobulin or IgG concentrations were often lower than those of chronic hepatitis (5). These data may gradually increase during the clinical course. The relationship between clinical course and clinical manifestation are proposed as shown in

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Acute-onset Autoimmune Hepatitis Treated with Living Donor-liver Transplantation.

Cited by 7 publications

References 17 publications

Clinical characteristics of fulminant‐type autoimmune hepatitis: an analysis of eleven cases

Clinical characteristics of fulminant‐type autoimmune hepatitis: an analysis of eleven cases

Recurrence of autoimmune hepatitis after liver transplantation without elevation of alanine aminotransferase

Acute-Onset Autoimmune Hepatitis

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