Clinical Features Of Drug-induced Autoimmune Hepatitis And FoxP3T-regs Expression In Blood

Objective To analyze DIAIH and AIH by clinical, laboratory examination, pathological features, research DIAIH with peripheral blood CD4+CD25+FoxP3+T-regs expression situation, explore its role in DIAIH, for differential diagnosis with AIH and provide evidence for treatment strategies.Methods Retrospective analysis of the second people’s hospital of tianjin diagnosed25cases DIAIH patients and diagnosed20cases AIH patients, biochemical, immunological indexes, and histopathological features. Fluid cytology method is used to detect CD4+CD25+FoxP3+T-regs of peripheral blood in frequency.Results1.DIAIH and AIH were same in the gender and age groups (P>0.05).2. DIAIH group cases, with traditional Chinese medicine (TCM) for the first (9/25,4%). DIAIH has no oneself immunopathy among one-level group patient.3. Lack of power, urine yellow, anorexia NaCha, there were no statistically significant difference in two group(P>0.05). Physical examinations were samilar (P>0.05).4. The patients on admission of ALT, AST, TBIL,ALB results are similar (P>0.05), group DIAIH γ-GT and ALP level higher than AIH group(P<0.05). But2weeks later, AST, γ-GT, ALP, TBIL difference had statistical significance(P<0.05).5. AIH, gamma globulin and IgG levels higher than DIAIH group (P<0.05), ANA and SMA, positive cases were similar between the two groups (P<0.05). The AIH diagnose is lower than AIH group (P<0.001).6. DIAIH group of pathology changes in eosinophil infiltration(11/25,44.0%), special Kupffer cells(6/25,24.0%), hepatocyte fatty degeneration (13/25,52.0%), and (or) capillary bile duct silting bile(9/25,36.0%), small bile duct hyperplasia (7/25,28.0%) incidence than AIH group. 7. Two groups’ peripheral blood CD4+CD25+FoxP3+Tregs(3.37%vs2.76%). By comparison, the difference was statistically significant (P=0.002).8. DIAIH,4cases (4/25,16%) combined with immunosuppressive therapy, liver function is normal. AIH,(7/20,35%) application of immunosuppressive therapy,13patients (13/20,65%) to protect liver alone protect liver treatment,6cases (6/13,46%) still has liver fluctuations within6months.Conclusion1. DIAIH and AIH take place in women, in middle-aged disease the most. In this study group, Chinese medicine is the first because of DIAIH. Unlike AIH, DIAIH no family history of autoimmune disease.2. Two groups common clinical symptoms is fatigue, anorexia NaCha, urine yellow.3. DIAIH agree with AIH, ANA, SMA as the main index of autoantibodies, but IgG, gamma globulin levels and diagnosis of AIH integral are lower than AIH.4. DIAIH more with liver pathology of eosinophil infiltration, brown particles composed of kupffer cells, vesicles of steatosis hepatocyte fatty degeneration and liver cells and (or) capillary bile duct silting bravery, small bile duct proliferation characteristics, and AIH with interface inflammation and liver cell rosette sample change as the main characteristics.5. DIAIH peripheral blood CD4+CD25+FoxP3+T regs, higher level than AIH, prompt monitoring FoxP3+T regs may help identify DIAIH and AIH.6. Treating2weeks DIAIH recover better than AIH patients. Most DIAIH liver injury after liver were symptomatic treatment can be restored, a few used immunosuppressive therapy and can clinical ease.