Y Miyake1, Y Iwasaki, K Sakaguchi, Y Shiratori. 1. Department of Internal Medicine, Kurashiki Riverside Hospital, Kurashiki, Japan. miyakeyasuhiro@hotmail.com
Abstract
BACKGROUND: Recently, unusual patients with autoimmune hepatitis, such as male patients, have increased. AIM: To assess clinical feature of Japanese males with type 1 autoimmune hepatitis compared with females. METHODS: We investigated consecutive 160 patients with type 1 autoimmune hepatitis, who consisted of 20 males and 140 females, with a median age of 55 (16-79) years. RESULTS: Compared with females, males had a lower frequency of definite diagnosis according to the revised scoring system proposed by the International Autoimmune Hepatitis Group (40% vs. 85%) and lower serum levels of immunoglobulin G [1932 (1085-3850) mg/dL vs. 2624 (1354-6562) mg/dL]. However, they were similar in age, form of clinical onset, symptomatic concurrent autoimmune disease, human leucocyte antigen DR status and frequency of cirrhosis at the time of diagnosis. The normalization of serum alanine aminotransferase levels within 6 months after the introduction of corticosteroid treatment was lower in males compared with females (73% vs. 93%). CONCLUSIONS: In male patients, a diagnosis of autoimmune hepatitis should be made carefully. In Japanese patients with a dominant frequency of human leucocyte antigen DR4, gender may affect the response to corticosteroid treatment.
BACKGROUND: Recently, unusual patients with autoimmune hepatitis, such as male patients, have increased. AIM: To assess clinical feature of Japanese males with type 1 autoimmune hepatitis compared with females. METHODS: We investigated consecutive 160 patients with type 1 autoimmune hepatitis, who consisted of 20 males and 140 females, with a median age of 55 (16-79) years. RESULTS: Compared with females, males had a lower frequency of definite diagnosis according to the revised scoring system proposed by the International Autoimmune Hepatitis Group (40% vs. 85%) and lower serum levels of immunoglobulin G [1932 (1085-3850) mg/dL vs. 2624 (1354-6562) mg/dL]. However, they were similar in age, form of clinical onset, symptomatic concurrent autoimmune disease, human leucocyte antigen DR status and frequency of cirrhosis at the time of diagnosis. The normalization of serum alanine aminotransferase levels within 6 months after the introduction of corticosteroid treatment was lower in males compared with females (73% vs. 93%). CONCLUSIONS: In male patients, a diagnosis of autoimmune hepatitis should be made carefully. In Japanese patients with a dominant frequency of human leucocyte antigen DR4, gender may affect the response to corticosteroid treatment.
Authors: Nikolaos K Gatselis; Kalliopi Zachou; George K Koukoulis; George N Dalekos Journal: World J Gastroenterol Date: 2015-01-07 Impact factor: 5.742