Clinical and pathological features of acute autoimmune hepatitis

Abstract

Abstract: Objective Analysis of clinical and pathological features of autoimmune hepatitis (AIH) patients of acute onset.Methods A total of 74 patients with AIH, aged (53.4 ± 11.3) years, were selected between May 2010 and November 2010. Among them, 28 patients with AIH of acute onset (acute group), the diagnosis should be in accordance with at least one of the following items: total bilirubin (TBil) ≥ 85.5 μmol/L, ALT (AST) ≥ 10 × normal limit, and 46 cases of non-acute onset (non-acute group). (±s) or [M(P₂₅, P₇₅)] represented measurement data, t-test or Kruskal-Wallis H test were used; (%) represented counting data, chi-square test were used.Results There were significant differences in TBil, ALT, AST, PT, INR, IgG, antinuclear antibody (ANA) and the degree of liver fibrosis between acute group and non-acute group of AIH (P<0.05). There was no significant difference in age, sex, WBC, PLT, anti-smooth muscle antibody (ASMA), anti-liver soluble antigen antibody (anti-SLA), anti-liver and kidney microsomal antibody (anti-LKM), anti-neutrophil cytoplasmic antibody (ANCA) and hepatitis inflammatory activity between the two groups (P>0.05). There were significant differences in jaundice, anorexia, yellow urine and oil weariness between acute group and non-acute group in AIH patients (P<0.05), but there was no significant difference in fatigue, ascites, abdominal pain, weight loss, lower limb edema and joint pain between the two groups (P>0.05).Conclusion In clinical practice, the number of AIH cases of acute onset is not uncommon, and it is difficult to identify these patients only through IAIHG score. Compared with non-acute AIH, there are significant differences in liver transaminase, coagulation index and degree of liver fibrosis in acute patients, which will help to distinguish them. In the clinical manifestations, jaundice, anorexia, yellow urine and oil-weariness are more significant in AIH of acute onset, which will help clinicians to find out in the early stage.

Key words: Autoimmune hepatitis, Antinuclear antibody, Liver fibrosis

NIE Hong, SONG Jie, SHI Niu. Clinical and pathological features of acute autoimmune hepatitis[J]. Chinese Hepatolgy, 2021, 26(6): 664-666.

References

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