{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T07:10:50Z","timestamp":1777360250480,"version":"3.51.4"},"reference-count":45,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>There is no gold standard for making the diagnosis of autoimmune hepatitis (AIH), and the diagnosis of acute onset AIH (A\u2010AIH) is most challenging. A\u2010AIH sometimes develops into acute liver failure with poor prognosis if the diagnosis is delayed. Therefore, it is most important for the better prognosis to diagnose non\u2010severe A\u2010AIH early and treat appropriately. However, features in the early stage of A\u2010AIH are unclear. We examined initial characteristics of non\u2010severe A\u2010AIH in detail and tried to find novel clinical features for the early diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical, biochemical, immunological, radiological, and histological features of 71 patients (54 women, mean age 57.9\u00a0\u00b1\u00a014.3\u00a0years) with non\u2010severe A\u2010AIH admitted to community hospitals between 2001 and 2022 were analyzed retrospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>Forty\u2010six had no symptom on onset and liver injuries were discovered by regular medical checkups. The mean duration from onset to consultation was 25.0\u00a0\u00b1\u00a029.3\u00a0days. Liver histology showed acute hepatitis in 59% and chronic hepatitis in 41%. Patients with symptoms revealed more male sex (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.039), higher alanine aminotransferase (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), higher total bilirubin (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and higher rate of histological acute hepatitis (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0013) than those without symptoms significantly. Male sex, presence of symptoms on onset, occurrence of jaundice in the course, and histological acute hepatitis were correlated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Sixty\u2010five percent of non\u2010severe A\u2010AIH patients were asymptomatic on onset, suggesting that A\u2010AIH would develop insidiously and present a longer clinical course than that reported. Male patients more often revealed true acute hepatitis clinically, biochemically, and histologically than female ones.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.16657","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T09:28:43Z","timestamp":1718098123000},"page":"2120-2128","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Analysis of autoimmune hepatitis with acute presentation in the early stage of illness"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8396-4531","authenticated-orcid":false,"given":"Keiichi","family":"Fujiwara","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiro","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Seikeikai 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