自己免疫性肝炎（AIH）診療ガイドライン（2016 年）

1 AIH 2016 2017 3 1 IgG 2013 2016 2017 3 COI 2016

2 2013 2 .. 5 .. 7 .. 9 .. 15 .. 20 .. 21 .. 23 I.. 23 QI -1 AIH .. 23 QI -2 .. 23 QI -3 .. 24 QI -4 .. 24 QI -5.

3 25 QI -6 .. 25 II. AIH .. 26 QII-1 .. 26 QII-2 .. 26 QII-3 .. 27 QII-4 .. 27 QII-5 .. 28 QII-6 .. 28 QII-7 .. 29 QII-8 2016 .. 29 QII-9 .. 29 QII-10 .. 30 QII-11 .. 30 QII-12 ( ) .. 31 III. AIH .. 32 QIII-1 .. 32 QIII-2 .. 32 QIII-3 .. 33 QIII-4 .. 33 QIII-5 .. 34 3 QIII-6.

4 34 QIII-7 .. 35 QIII-8 .. 35 QIII-9 .. 36 QIII-10 .. 36 QIII-11 .. 37 QIII-12 .. 37 QIII-13 .. 38 QIII-14 .. 38 QIII-15 .. 39 QIII-16 ? .. 39 QIII-17 ? .. 40 IV AIH .. 42 QIV-1 .. 42 QIV-2 .. 42 QIV-3 .. 43 QIV-4 .. 43 QIV-5 AIH .. 44 QIV-6.

5 44 QIV-7 AIH .. 44 QIV-8 .. 45 V.. 46 QV-1 .. 46 QV-2 .. 46 QV-3 .. 47 QV-4 AIH .. 47 QV-5 AIH .. 48 VI. AIH .. 49 QVI-1 .. 49 QVI-2 .. 49 QVI-3 .. 50 QVI-4 .. 50 QVI-5 .. 51 .. 52 4 (AIH) AIH (2013 ) 1993/01/01 2015/12/31 PubMed-Medline Cochrane Library AIH CQ [ ]

6 * American Association for the Study of Liver Diseases British Society of Gastroenterology European Association for the Study of Liver AIH 1) Manns MP, Czaja AJ, Gorham JD, et al. Diagnosis and Management of Autoimmune Hepatitis. Hepatology 2010; 51: 2193-213. 2) Gleeson D, Heneghan MA. British Society Gastroenterology (BSG) guidelines for management of autoimmune hepatitis.

7 Gut 2011; 1611-29. 3) European Association for the Study of Liver. EASL Clinical Practice Guidelines: Autoimmune hepatitis. J Hepatol 2015; 971-1004. GRADE Minds ( ) (2014 ) A B C D . ( ) COI 5 1. Autoimmune hepatitis: AIH 1)-6) AIH 1950 Waldenstr m7), 1951 Zimmerman8), Kunkel9) 1956 Mackay LE lupoid hepatitis 10) 1965 Mackay Autoimmune hepatitis 11) AIH 1979 12)-17)

8 1996 AIH 18) 2009 2013 19) 1993 AIH (IAIHG) 20) 1999 21) 2008 22) AIH 23), 24) 25) AIH 26) IgG4 IgG4 IgG4 AIH 27) 1) . (2013 ). 2) Krawitt EL. Autoimmune hepatitis. N Engl J Med 2006; 354: 54-66.

9 3) Czaja A, Manns MP. Advances in the diagnosis, pathogenesis, and management of autoimmune hepatitis. Gastroenterology 2010; 139: 58-72. 4) Manns MP, Czaja AJ, Gorham JD, et al. Dignsosis and management of autoimmune hepatitis. Hepatology 2010; 51: 2193-213. 5) Glesson D, Heneghan MA. British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis. Gut 2011; 60: 1611-29. 6) European Association for the Study of the Liver. EASL clinical practice guidelines: Autoimmune hepatitis. J Hepatol 2015; 63: 971-1004. 7) Waldenstr m J. Leber, Blutproteine und Nahrungseiweisse.

10 Dtsch Gesellsch Verd Stoffw 1950; 15: 113-9. 8) Zimmerman HJ, Heller P, Hill RP. Extreme hyperglobulinema in subacute hepatic necrosis. N Engl J Med 1951; 244: 245-9. 9) Kunkel HG, Ahrens EH Jr, Eisenmenger WJ, et al. Extreme hypergammaglobulinemia in young women with liver disease of unknown etiology. J Clin Invest 1951; 30: 654. 10) Cowling DC, Mackay IR, Taft LI. Lupoid hepatitis. Lancet 1956; 271: 1323-6. 11) Mackay IR, Weiden S, Hasker J. Autoimmune hepatitis. Ann N Y Acad Sci 1965; 124: 767-80. 12) Monna T, Kuroki T, Yamamoto S. Autoimmune hepatitis: the present status in Japan. Gastroenterol Jpn 1985; 20: 260-72.