Abstract | BACKGROUND: AIMS: METHODS: During 28 years from 1979 through 2007, 48 patients with definite diagnosis of AIH received long-term corticosteroid therapy (median 9 years [range: 5-28 years]) in a single Japanese center. They were followed for transaminase levels and received liver biopsy before and after the treatment. RESULTS: DR4 was detected in 32 and DR14 in 11 patients; seven possessed both DR4 and DR14. DR4 was more frequent in AIH patients than in the general population (67% vs. 22%), while DR14 was comparably frequent between them (23% vs. 17%). Overall, biochemical response was achieved in 43 (90%) of the 48 patients. The sustained biochemical response to a maintenance prednisolone dose < 10 mg was gained more frequently in the patients with than without DR14 (10/11 [91%] vs. 10/37 [27%], P < 0.001). Marked histological improvement with a decrease in histology activity index (HAI) score by > 2 points was achieved in 31 of the 32 (97%) biochemical responders. Histological aggravation with an increase in HAI score occurred in 4 of the 16 (25%) patients without biochemical response (non-responders and relapsers combined), but in none of the 32 responders. CONCLUSION: Long-term immunosuppressive treatment can improve the outcome of Japanese patients with AIH, and DR14 is associated with excellent biochemical response.
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Authors | Yoshiyuki Suzuki, Kenji Ikeda, Miharu Hirakawa, Yusuke Kawamura, Hiromi Yatsuji, Hitomi Sezaki, Tetsuya Hosaka, Norio Akuta, Masahiro Kobayashi, Fumitaka Suzuki, Satoshi Saitoh, Yasuji Arase, Mariko Kobayashi, Yuzo Miyakawa, Hiromitsu Kumada |
Journal | Digestive diseases and sciences
(Dig Dis Sci)
Vol. 55
Issue 7
Pg. 2070-6
(Jul 2010)
ISSN: 1573-2568 [Electronic] United States |
PMID | 20094777
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Autoantibodies
- Biomarkers
- HLA-DR Antigens
- HLA-DR Serological Subtypes
- HLA-DR14
- Immunosuppressive Agents
- Prednisolone
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Topics |
- Adult
- Aged
- Autoantibodies
(analysis, immunology)
- Biomarkers
(blood)
- Biopsy, Needle
- Cohort Studies
- Female
- Follow-Up Studies
- HLA-DR Antigens
(drug effects, immunology)
- HLA-DR Serological Subtypes
- Hepatitis, Autoimmune
(drug therapy, immunology, pathology)
- Humans
- Immunohistochemistry
- Immunosuppressive Agents
(administration & dosage)
- Laparoscopy
- Male
- Middle Aged
- Prednisolone
(therapeutic use)
- Probability
- Recurrence
- Retrospective Studies
- Risk Assessment
- Severity of Illness Index
- Statistics, Nonparametric
- Treatment Outcome
- Young Adult
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