{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:49:06Z","timestamp":1790293746782,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2012,10,22]],"date-time":"2012-10-22T00:00:00Z","timestamp":1350864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The number of patients with autoimmune hepatitis (<jats:styled-content style=\"fixed-case\">AIH<\/jats:styled-content>) showing acute presentation has increased. This study aimed to assess their prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A survey of <jats:styled-content style=\"fixed-case\">AIH<\/jats:styled-content> patients by sending questionnaires was performed, and 96 patients showing acute presentation were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age was 58 years and 78 patients (81%) were female. Eighty\u2010four patients (88%) were positive for antinuclear antibody and\/or anti\u2010smooth muscle antibody. The median serum immunoglobulin <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content> level was 2252\u2009mg\/<jats:styled-content style=\"fixed-case\">dL<\/jats:styled-content>. Twenty\u2010five patients (26%) showed histological acute hepatitis. As initial treatment, 88 patients (92%) were treated with corticosteroid, and 28 of them received pulse steroid treatment. Overall, 11 patients (11%) reached fatal outcomes (nine death and two liver transplantation). Patients with histological acute hepatitis showed higher serum bilirubin levels, lower prothrombin activities and higher prothrombin time\u2013international normalized ratios (<jats:styled-content style=\"fixed-case\">PT\u2010INR<\/jats:styled-content>) and reached fatal outcomes more frequently. With a multivariate logistic regression analysis, prothrombin activity and <jats:styled-content style=\"fixed-case\">PT\u2010INR<\/jats:styled-content> at presentation was associated with fatal outcomes. Nine of 13 patients (69%) showing prothrombin activity of 40% or lower at presentation and nine of 19 patients (47%) showing <jats:styled-content style=\"fixed-case\">PT\u2010INR<\/jats:styled-content> of 1.5 or higher reached fatal outcomes. Furthermore, of 13 patients showing prothrombin activity of 40% or lower and\/or <jats:styled-content style=\"fixed-case\">PT\u2010INR<\/jats:styled-content> of 1.5 or higher at presentation who were treated with pulse steroid treatment, four (31%) died from infectious disease.<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#hepr1109-note-9001\"\/><\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prothrombin activity and <jats:styled-content style=\"fixed-case\">PT\u2010INR<\/jats:styled-content> are prognostic factors for <jats:styled-content style=\"fixed-case\">AIH<\/jats:styled-content> showing acute presentation. Physicians should pay attention to the development of infectious disease when pulse steroid treatment is performed.<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#hepr1109-note-9001\"\/><\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1872-034x.2012.01109.x","type":"journal-article","created":{"date-parts":[[2012,9,27]],"date-time":"2012-09-27T01:15:00Z","timestamp":1348708500000},"page":"630-638","source":"Crossref","is-referenced-by-count":39,"title":["Prognosis of autoimmune hepatitis showing acute presentation"],"prefix":"10.1111","volume":"43","author":[{"given":"Kazuhide","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Miyake","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromasa","family":"Ohira","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Rheumatology Fukushima Medical University School of Medicine  Fukushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Hepatology Toranomon Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikio","family":"Zeniya","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine Jikei University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morikazu","family":"Onji","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Metabology Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohito","family":"Tsubouchi","sequence":"additional","affiliation":[{"name":"Department of Digestive and Lifestyle\u2010related Disease Health Research, Human and Environmental Sciences Kagoshima University Graduate School of Medical and Dental Sciences  Kagoshima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Intractable Liver and Biliary Diseases Study Group of Japan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,10,22]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"113","article-title":"Leber, blutproteine und nahrungseiweisse","volume":"15","author":"Waldenstr\u00f6m J","year":"1950","journal-title":"Dtsch Ges Verd 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