Analysis Of The Clinical Features Of 125 Cases With Autoimmune Liver Disease

Objective Analysis of clinical characteristics in patients with autoimmune liver disease,for the diagnosis and differential diagnosis of autoimmune liver disease to provide more theoretical basis.Methods It’s a retrospective study.We collected data of 125 patients clearly diagnosed with autoimmnue liver disease(AILD)from January 2010 to September2016 at the general hospital of Ningxia Medical University,including 38 cases of autoimmune hepatitis(AIH),82 cases of primary biliary cholangitis(PBC)and 5cases of primary sclerosing cholangitis(PSC).The general condition,clinical manifestations,complications,laboratory examination,imageological examination and histopathologic characteristics of cases were analyzed and summarized.Results We found that autoimmune liver disease occurred in middle and elder women,the average age was(58.00±13.26)years old,male and female proportion was 1:4.95.There were no differences in gender composition and age.Clinical manifestations of autoimmune liver disease lacked of specificity.Biochemical indicators of AIH group was given priority to the elevated alanine aminotransferase(ALT)and aspartate aminotransferase(AST),however,the alkaline phosphatase(ALP),glutaml transpeptidase(GGT)and total bilirubin(TBIL)levels increased obviously in PBC and PSC group.The albumin(ALB)level of three group were all reduced,however,the globulin(GLB)level of AIH was higher than PBC and PSC group.Immunoglobulin G(Ig G)level of AIH group was obviously higher than PBC group,immunoglobulin M(Ig M)level of PBC groupwas higher than AIH group.There was no obvious changes of PSC group in Ig G and Ig M levels.The antinuclear antibody(ANA)positive rate of AIH group was no difference compared with PBC group,however,on the types of ANA,AIH was given priority to the type of spot type(42.42%)and PBC was given priority to the cytoplasm particles type(50.75%).The positive rate of antismooth muscle antibody(ASMA)was higher than PBC group.Anti-liver kidney microsomal type 1antibody(LKM-1),anti-liver cytosolic type 1 antibody(LC-1)and soluble liver antigen/liver pancreas(SLA/LP)antibodies were all specific autoantibodies for AIH.However,the specific autoantibodies of PBC were antimitochondrial antibody(AMA)or antimitochondrial antibody type 2(AMA-M2).There was no specific autoantibody for PSC.Abdominal ultrasonography and abdomimal computed tomography detected cirrhosis and ascites in AIH group and PBC group,which had no differences.In PSC group,abdominal ultrasonography and abdomimal computed tomography didn’t discover cirrhosis and ascites lesions,and the presentation of abdomimal computed tomography was the expansion of intrahepatic and extrahepatic bile duct.AIH group and PBC group didn’t discover bile duct lesion in magnetic resonance cholangiopancreatography or endoscopic retrograde cholangiopancreatography,but the presentations of PSC group were deadwood lesion,stiffness,segmental stenosis of intrahepatic and extrahepatic bile duct.The histological presentations of AIH were hepatocyte degeneration and necrosis,however,the presentations of PBC were small bile duct hyperplasia and cholestasis.Conclusion 1.AILD occurred in middle and elder women;2.AILD lacked specificity in clinical manifestations;3.The clinical characteristics of AIH expressed that ALT,AST and Ig G levels increased,common autoantibodies had ANA,ASMA,specific autoantibodies had LKM-1,SLA/LP,LC-1,the manifestationof histology was liver parenchyma damage;4.The clinical characteristics of PBC showed that ALP,GGT,TBIL and Ig M levels increased,specific autoantibodies had AMA or AMA-M2,the manifestation of histology was bile duct injury;5.The clinical features of PSC showed that ALP,GGT and TBIL levels increased,the imageological presentations showed characteristic intrahepatic and extrahepatic bile duct lesions.