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Autoimmune-like hepatitis after allogeneic hematopoietic stem cell transplantation: humoral hepatic GvHD

Bone Marrow Transplantation volume 52, pages 151–153 (2017)Cite this article

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Several cases of autoimmune hepatitis (AIH)-like lesions following allogeneic hematopoietic stem cell transplantation (allo-HSCT) have been reported.1, 2, 3, 4 In general, AIH is a chronic inflammatory disorder characterized by interface hepatitis, increased Ig, autoantibody levels and a dramatic response to immunosuppression. Much evidence supports a central role of T-cell dysfunction in the pathogenesis of AIH, although autoantibodies produced by plasma cells also contribute to the pathogenesis.5 Hepatic GvHD is one of the most important hepatic complications after allo-HSCT. It is characterized by lymphocytic cholangiolitis with apoptosis and has different pathological features from interface hepatitis of AIH.6 Lobular hepatitis type of hepatic GvHD is proposed; however, its features are also different from AIH.7

The incidence and clinical features of patients with AIH-like lesions following allo-HSCT is not well understood; therefore, the aim of this study is to clarify the clinical manifestations of this hepatic complication by comparing it with hepatic GvHD. We used the term ‘autoimmune-like hepatitis (AILH)’ to describe this hepatic disorder because this lesion is not ‘autoimmune’ in the setting of allo-HSCT. We investigated the liver biopsy specimens after allo-HSCT between 1991 and 2010 in our institute. This study was approved by the institutional review board of Japanese Red Cross Nagoya Daiichi Hospital and all patients provided their written, informed consent.

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Authors and Affiliations

  1. Department of Hematology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan

    D Koyama, E Yokohata, K Watakabe, K Onodera, T Goto, A Seto, K Watanabe, Y Ozawa & K Miyamura

  2. Department of Pathology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan

    M Ito

  3. Department of Gastroenterology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan

    M Doisaki & T Yamaguchi

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  1. D Koyama
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  2. M Ito
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  3. E Yokohata
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  4. K Watakabe
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  6. T Goto
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  7. A Seto
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  8. K Watanabe
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  9. M Doisaki
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  10. Y Ozawa
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  11. T Yamaguchi
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  12. K Miyamura
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Correspondence to D Koyama.

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Koyama, D., Ito, M., Yokohata, E. et al. Autoimmune-like hepatitis after allogeneic hematopoietic stem cell transplantation: humoral hepatic GvHD. Bone Marrow Transplant 52, 151–153 (2017). https://doi.org/10.1038/bmt.2016.202

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