Studies on autoimmune hepatitis type I,II,and III

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Recently autoantibodies specific for liver diseases are identified and European investigators attempted to classify autoimmune hepatitis (AIH) into 4 groups by autoantibodies. The aims of present study are to investigate the frequency and significance of seropositivity of such autoantibodies in Japanese patients with chronic liver diseases.1.Antibodies to liver/kidney microsomal type 1 (anti-LKM1) which were proposed as a maker of AIH type II were found in 2.5% of patients with chronic hepatitis C,but not in other patients including autoimmune hepatitis. All 6 patients positive for anti-LKM1 were adults, and had a long duration of illness (range, 2 to 8 years). Three of them had chronic thyroiditis. There were no obvious difference in age, sex ratio and laboratory findings comparing to those with 50 patients with chronic hepatitis C negative for anti-LKM1. Three of 5 patients responded well to interferon alpha therapy. Those findings suggest that our 6 patients should be diagnosed as chronic hepatitis C positive for anti-LKM1 or AIH type IIb. No patients of AIH positive for anti-LKM1 were found in the present, study, indicating that AIH type IIa is very rare in Japan.2.Antibodies to soluble liver antigens (anti-SLA) were found in 2 out of 358 patients with chronic liver disease, suggesting that AIH type III must be very rare in Japan. One was diagnosed as AIH and the other one was diagnosed as chronic hepatitis C.It would be of interest to follow up these 2 patients.3.Patients with chronic hepatitis positive for high titers of SMA more than 1 : 160 dilution were found in 16 out of 358 patients. Some of them have high serum gamma-globulinemia. Interestingly, 10% of chronic hepatitis non A,B and C were soropositive for SMA.Those patients seem to be AIH type III.