Current trends in the diagnosis and treatment of autoimmune hepatitis in Japan
Article first published online: 2 NOV 2011
© 2011 The Japan Society of Hepatology
Volume 42, Issue 2, pages 131–138, February 2012
How to Cite
Ohira, H. and Takahashi, A. (2012), Current trends in the diagnosis and treatment of autoimmune hepatitis in Japan. Hepatology Research, 42: 131–138. doi: 10.1111/j.1872-034X.2011.00904.x
- Issue published online: 16 JAN 2012
- Article first published online: 2 NOV 2011
- Received 4 August 2011; revision 25 August 2011; accepted 28 August 2011.
- acute presentation;
- fulminant hepatitis;
- overlap syndrome;
- primary biliary cirrhosis
While a certain international consensus has been reached regarding the diagnosis and treatment of autoimmune hepatitis (AIH), there are some unique clinical characteristics of AIH in Japan. For diagnosis of AIH using the new simplified criteria proposed by the International Autoimmune Hepatitis Group, it is necessary to re-evaluate the antibody titer determined by using HEp-2 cells, which are widely used in Japan, and the finding of emperipolesis in liver histology, although the criteria are useful for rapid identification of AIH in routine clinical practice. The use of azathioprine as first-line therapy for AIH is limited in Japan because the drug is not covered by the Japanese national health insurance. Concomitant use of ursodeoxycholic acid (UDCA) to reduce corticosteroids and use of UDCA as monotherapy are therefore considered promising. Moreover, a relatively good survival rate has been reported in patients who developed AIH-induced acute liver failure and underwent living-donor liver transplantation. Current trends in the diagnosis and treatment of AIH in Japan are described in this report with a review of recent findings.