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Clinical features of autoimmune hepatitis and comparison of two diagnostic criteria in Korea: a nationwide, multicenter study

Authors
 Bo Hyun Kim  ;  Yoon Jun Kim  ;  Sook-Hyang Jeong  ;  Won Young Tak  ;  Sang Hoon Ahn  ;  Youn Jae Lee  ;  Eun Uk Jung  ;  Jung Il Lee  ;  Jong Eun Yeon  ;  Jae Seok Hwang  ;  Soon Ho Um  ;  Yeon Seok Seo  ;  Young Seok Kim  ;  Byung Cheol Song  ;  Ju Hyun Kim  ;  Young Kul Jung  ;  Choong Kee Park  ;  Kyung-Ah Kim  ;  Hyun Ju Min  ;  Eun Young Cho  ;  Eom Seok Lee  ;  So Young Kwon  ;  Hee Bok Chae  ;  Dong Joon Kim  ;  Su Rin Shin 
Citation
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol.28(1) : 128-134, 2013-01 
Journal Title
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 
ISSN
 0815-9319 
Issue Date
2013-01
MeSH
Adult ; Aged ; Aged, 80 and over ; Anti-Inflammatory Agents / therapeutic use ; Antibodies, Antinuclear / metabolism* ; Autoantibodies / metabolism* ; Azathioprine / therapeutic use ; Chi-Square Distribution ; Female ; Hepatitis, Autoimmune / complications ; Hepatitis, Autoimmune / diagnosis* ; Hepatitis, Autoimmune / drug therapy ; Hepatitis, Autoimmune / metabolism* ; Humans ; Immunosuppressive Agents / therapeutic use ; Liver Cirrhosis / complications ; Liver Failure / complications ; Male ; Middle Aged ; Practice Guidelines as Topic ; Predictive Value of Tests ; Prednisolone / therapeutic use ; Republic of Korea ; Retrospective Studies ; Statistics, Nonparametric ; Young Adult
Abstract
Background and aim: As a rare liver disease, little is known about autoimmune hepatitis (AIH). This study investigated the clinical features and compared two diagnostic criteria of AIH in Korea. Methods: A nationwide, multicenter, retrospective analysis was done of data of adult patients diagnosed with AIH from January 2005 to December 2009. Results: The enrolled patients (n = 343; mean age, 52.8 years; range, 19-87 years; 12% male, 88% female) met diagnostic criteria of AIH according to the revised original criteria (n = 311) or the simplified criteria (n = 250). At diagnosis, 30.6% were asymptomatic, 22.7% were cirrhotic, and 4.3% displayed hepatic decompensation. The positive results for anti-nuclear antibody, smooth muscle antibody, and anti-liver/kidney microsomal antibody were 94.2%, 23.0%, and 2.9%, respectively. Definite AIH and probable AIH according to the revised original criteria were 24.8% and 65.3%, respectively, while those according to the simplified criteria were 34.4% and 38.5%, respectively. The diagnostic sensitivity and positive predictive value of simplified criteria in comparison with the revised original criteria were 69.9% and 86.4%, respectively. As an initial therapy, corticosteroid (37.7%) or corticosteroid with azathioprine (36.8%) was administered. Remission, incomplete response, and treatment failure were noted with 85.7%, 10.5%, and 3.9% of patients, respectively. Conclusions: Autoimmune hepatitis in Korea is mostly type I, showing a mean age of 53 years with comparable clinical features to other countries. The concordant rate of the two diagnostic criteria was rather low with modest sensitivity of the simplified criteria. Further studies on the validation of the diagnostic criteria are warranted.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1440-1746.2012.07292.x
DOI
10.1111/j.1440-1746.2012.07292.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/178486
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