High level of persistent liver injury is one of clinical characteristics in treatment-na  ve acute onset XXXX : experience in a community hospital.

@entity1 @entity3929 @entity39 @entity775
BACKGROUD: There is yet no gold standard for making the diagnosis of acute onset @entity775 (A-AIH). Novel histological characteristics have been reported, but etiologies other than AIH could show similar histological pattern. We attempted to determine what clinical characteristics we should consider as A-AIH different from other etiologies, and to whom histological characteristics should be applied for the diagnosis. METHODS: Clinical, biochemical, immunological and pathological features of 46 @entity1 (35 @entity1 , mean age 55.9    14.2 years) with non-severe A-AIH admitted to a community hospital between 2001 and 2015 were analyzed. RESULTS: Immunoglobulin G level was normal in 28%, and anti-nuclear antibody titer was < x 80 in 28%. Liver histology of 49% showed acute form and 51% chronic one. Centrilobular @entity39 /collapse and/or plasma cell accumulation, rosette formation were characteristic for A-AIH. High levels of @entity3929 aminotranferase persisted in 21 @entity1 who could be observed for equal to or more than 4 weeks before the start of treatment. CONCLUSIONS: Long persistence of high levels of ALT would be one of clinical features for considering A-AIH along with conventional features. Histological diagnostic features should be applied for such @entity1 . Guidelines for diagnosing A-AIH should be urgently drawn up. This article is protected by copyright. All rights reserved.
