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Autoimmune hepatitis and IgG4-related disease

World Journal of Gastroenterology 2019年第19期25卷 2308-2314页

作者： Kosuke Minaga Tomohiro Watanabe hobyung chung Masatoshi Kudo Department of Gastroenterology and Hepatology Kindai University Faculty of Medicine Department of Gastroenterology and Hepatology Kobe City General Hospital

IgG4-related disease(IgG4-RD) is a chronic-fibroinflammatory disorder affecting a wide range of organs. Elevation of serum IgG4 concentrations and abundant infiltration of IgG4-expressing plasma cells are key diagnostic features of this autoimmune disease. Although common organ involvement of IgG4-RD includes the salivary glands, pancreas, and bile duct, hepatic involvement is less well established. Recently, five studies identified a subtype of autoimmune hepatitis(AIH), called IgG4-associated AIH(IgG4-AIH). IgG4-AIH is diagnosed based on significant accumulation of IgG4-expressing plasmacytes in the liver in patients who met the diagnostic criteria for classical AIH. Although four of the five reports regarded IgG4-AIH based on hepatic accumulation of IgG4-positive cells alone, one report diagnosed IgG4-AIH based on both hepatic accumulation of IgG4-positive cells and elevated serum concentrations of IgG4. IgG4-AIH diagnosed based on the latter criteria may be a hepatic manifestation of IgG4-RD whereas IgG4-AIH diagnosed based on the former criteria may be a subtype of AIH. In this review article, we summarize and discuss clinicopathological features of IgG4-AIH.

关键词： Autoimmune hepatitis IgG4 IgG4-related disease IgG4-associated autoimmune hepatitis

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Autoimmune hepatitis and primary sclerosing cholangitis after direct-acting antiviral treatment for hepatitis C virus:A case report

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World Journal of Hepatology 2024年第2期16卷 286-293页

作者： Yoshiki Morihisa hobyung chung Shuichiro Towatari Daisuke Yamashita Tetsuro Inokuma Department of Gastroenterology and Hepatology Kobe City Medical Center General HospitalKobe 650-0047HyogoJapan Department of Pathology Kobe City Medical Center General HospitalKobe 650-0047HyogoJapan

BACKGROUND Chronic hepatitis C virus(HCV)infection is a major global health concern that leads to liver fibrosis,cirrhosis,and *** containing direct-acting antivirals(DAAs)have become the mainstay of HCV treatment,achieving a high sustained virological response(SVR)with minimal adverse *** SUMMARY A 74-year-old woman with chronic HCV infection was treated with the DAAs ledipasvir,and sofosbuvir for 12 wk and achieved ***-four weeks after treatment completion,the liver enzyme and serum IgG levels increased,and antinuclear antibody became positive without HCV viremia,suggesting the development of autoimmune hepatitis(AIH).After liver biopsy indicated AIH,a definite AIH diagnosis was made and prednisolone was *** treatment was effective,and the liver enzyme and serum IgG levels ***,multiple strictures of the intrahepatic and extrahepatic bile ducts with dilatation of the peripheral bile ducts appeared on magnetic resonance cholangiopancreatography after 3 years of achieving SVR,which were consistent with primary sclerosing *** The potential risk of developing autoimmune liver diseases after DAA treatment should be considered.

关键词： Liver Hepatitis C virus Autoimmune hepatitis Primary sclerosing cholangitis Immune system Case report

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