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Dig Liver Dis. 2016 Mar;48(3):302-8. doi: 10.1016/j.dld.2015.10.005. Epub 2015 Oct 22.

Immunoglobulin G4-associated autoimmune hepatitis may be found in Western countries.

Author information

1
University Hospital of Nice, Digestive Centre, Nice, France; National Institute of Health and Medical Research (INSERM), U1065, Team 8, "Hepatic Complications in Obesity", Nice, France; University of Nice-Sophia-Antipolis, College of Medicine, Nice, France.
2
University Hospital of Nice, Digestive Centre, Nice, France; National Institute of Health and Medical Research (INSERM), U1065, Team 8, "Hepatic Complications in Obesity", Nice, France; University of Nice-Sophia-Antipolis, College of Medicine, Nice, France. Electronic address: anty.r@chu-nice.fr.
3
University Hospital of Nice, Digestive Centre, Nice, France; University of Nice-Sophia-Antipolis, College of Medicine, Nice, France; University Hospital of Nice, Biological Center, Nice, France.
4
University Hospital of Nice, Biological Center, Nice, France.
5
National Institute of Health and Medical Research (INSERM), U1065, Team 8, "Hepatic Complications in Obesity", Nice, France; University of Nice-Sophia-Antipolis, College of Medicine, Nice, France.
6
Hepato-biliary Centre, Paul Brousse, Villejuif, DHU Hepatinov, France.

Abstract

BACKGROUND:

Immunoglobulin G4-related disease is a multi-systemic autoimmune disease. The sole involvement of the liver has been recently reported in Japanese patients and named "immunoglobulin G4-associated autoimmune hepatitis".

AIM:

To examine the baseline and the 2-year follow-up characteristics of non-Asian patients with immunoglobulin G4-associated autoimmune hepatitis compared to patients with classical autoimmune hepatitis.

METHODS:

This was a retrospective study of patients who had undergone liver biopsy between March 2009 and January 2012 before starting any treatment. All patients were treated according to the guidelines. Immunoglobulin G4-associated autoimmune hepatitis was diagnosed according to Umemura's histological definition: at least 10 positive immunoglobulin G4-plasma cells per high power field.

RESULTS:

Among 28 enrolled patients (males 39%, median age 54 years): 7 had immunoglobulin G4-associated autoimmune hepatitis (25%) and 21 had classical hepatitis; fibrosis and activity stages were F1: 57%, F2: 11%, F3: 11%, F4: 21% and A1: 18%, A2: 39%, A3: 43%. Alanine aminotransferase (ALT) activity and serum immunoglobulin G levels were similar in the two groups at baseline and at 2 years. Complete biochemical response (normal ALT) was similar in immunoglobulin G4-associated autoimmune hepatitis and classical hepatitis (67% vs. 59% at 2 years, p=0.74).

CONCLUSION:

Immunoglobulin G4-associated autoimmune hepatitis has been observed in Western patients and seems to evolve in a similar manner to classical hepatitis.

KEYWORDS:

Autoimmune hepatitis; Immunoglobulin G; Immunoglobulin G4-associated autoimmune hepatitis; Plasma cells

PMID:
26553036
DOI:
10.1016/j.dld.2015.10.005
[Indexed for MEDLINE]

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