{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T19:54:59Z","timestamp":1787082899011,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,11,22]],"date-time":"2013-11-22T00:00:00Z","timestamp":1385078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Autoimmune hepatitis is an uncommon chronic progressive inflammatory disease of the liver, characterised by hypergammaglobulianemia, circulating autoantibodies, and interface hepatitis histologically. It is traditionally thought to be a disease of young women. However, recent epidemiological and retrospective studies suggest that it might be a disease predominantly of older women. Studies of <jats:styled-content style=\"fixed-case\">AIH<\/jats:styled-content> in elderly patients have been fairly limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate the differences in the clinical presentations and the management of <jats:styled-content style=\"fixed-case\">AIH<\/jats:styled-content> in the elderly and the younger patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a search on <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content> (from 1946), PubMed (1946) and <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content> (1949) through to November 2013 using the terms \u2018autoimmune hepatitis in the elderly\u2019, and the combinations of \u2018Autoimmune hepatitis\u2019 <jats:styled-content style=\"fixed-case\">AND<\/jats:styled-content> the following terms: \u2018elderly\u2019, \u2018aging\u2019, \u2018older patients\u2019, and \u2018older\u2019. The reference lists of relevant articles were also searched for appropriate studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1063 patients were identified with <jats:styled-content style=\"fixed-case\">AIH<\/jats:styled-content> in 10 retrospective studies. The definition of \u2018elderly\u2019 ranged from 60 to 65\u00a0years; 264 elderly and 592 younger patients were included for analysis. Elderly, 24.8%, were more likely to present asymptomatically, cirrhotic at presentation and <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DR<\/jats:styled-content>4\u2010positive. They are less likely to be <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DR<\/jats:styled-content>3\u2010positive and to relapse after treatment withdrawal after complete remission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">AIH<\/jats:styled-content> is an important differential in elderly patients with cirrhosis or abnormal <jats:styled-content style=\"fixed-case\">LFT<\/jats:styled-content>s. Elderly are more likely to be cirrhotic and asymptomatic at presentation. Glucocorticoids use should be readily considered in the elderly patients as the current evidence suggests that they respond well to the therapy, with less relapse after treatment withdrawal.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.12563","type":"journal-article","created":{"date-parts":[[2013,11,23]],"date-time":"2013-11-23T00:56:56Z","timestamp":1385168216000},"page":"117-124","source":"Crossref","is-referenced-by-count":63,"title":["Systematic review with meta\u2010analysis: clinical manifestations and management of autoimmune hepatitis in the elderly"],"prefix":"10.1111","volume":"39","author":[{"given":"J.","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nepean Hospital Penrith NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. D.","family":"Eslick","sequence":"additional","affiliation":[{"name":"The Whiteley\u2010Martin Research Centre Discipline of Surgery The Sydney Medical School Nepean Penrith NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Weltman","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nepean Hospital Penrith NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,11,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840180435"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(99)80297-9"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.01.037"},{"key":"e_1_2_7_5_1","volume-title":"Leber, Bluetproteine und Nahrungseiweiss Stoffwechsel Krankheiten, Sonderband","author":"Waldenstrom J","year":"1950"},{"key":"e_1_2_7_6_1","first-page":"654","article-title":"Extreme hypergammaglobulinaemia in young women with liver disease of unknown aetiology","volume":"30","author":"Kunkel HG","year":"1951","journal-title":"J Clin Invest"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(56)90003-1"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1746.2001.02646.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2010.06384.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-011-0421-y"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00135"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_7_15_1","first-page":"157","article-title":"A fail\u2010safe N for effect size in meta\u2010analysis","volume":"8","author":"Orwin R","year":"1983","journal-title":"J Educ Stat"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/90.4.289"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/26.6.441"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2001.03782.x"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2005.02403.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2005.02488.x"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21074"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2006.04.007"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(10)60978-X"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.03104.x"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.46.0420"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1233530"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2003.01389.x"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2010.04241.x"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(00)00095-7"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(93)90157-8"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510250211"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.12563","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.12563","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T08:43:46Z","timestamp":1696495426000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.12563"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,11,22]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2014,1]]}},"alternative-id":["10.1111\/apt.12563"],"URL":"https:\/\/doi.org\/10.1111\/apt.12563","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,11,22]]}}}