Analysis Of The Clinical Characteristics Of Autoimmune Liver Disease

Objective: In order to deepen our understanding and provide early diagnostic value of Autoimmune hepatitis(AIH)and Primary biliary Cirrhosis(PBC),which are the two types of Autoimmune liver disease(AILD),we analysed the clinical characteristics and correlated examinations of the diseases.Methods: This research was a retrospective study.we collected 68 AILD patients from Yijishan Hospital and The people's hospital of Chizhou between January 2011 and November 2015.The AILD patients can be divided into two groups,which were 42 cases of AIH patients and 26 cases of PBC patients.Statistical analysed of the clinical characteristics and correlated examinations of AIH and PBC patients,and discussed the value of the results in the diagnosis and differentiating diagnosis between them.Results: As the two types of AILD,AIH and PBC had many similarities between high risk populations,clinical performance,laboratory results,imaging tests and histopathology.For high risk populations,AILD used to appear mostly in women,especially perimenopausal women(33.82% AILD patients were 50-60 years old),the sex differences in AIH group is more obvious,and the average age of AIH was earlier than the PBC group(P<0.05).Most AILD patients lacked of typical symptoms,which usually consisted fatigue,poor appetite,jaundice,skin pruritus,epigastric discomfort and so on.Part of AILD patients combined with other immune-related diseases.When we compared between the two groups,we found that AIH group had more patients with the symptom of fatigue(66.67%),while PBC patients had higher proportion of jaundice (53.85%)and skin pruritus(34.62%),all the differences were significant(P<0.05).However,28.57% patients of AIH,23.08% patients of PBC had no obvious symptoms,it suggested that AIH and PBC could be the diseases with insidious early symptom.The erythrocyte sedimentation rate in AILD patients became faster in varying degrees,but there was no significant statistical differences.The numbers of white blood cell,red blood cell and platelets of PBC group were significantly lower than the numbers of AIH group respectively(P<0.05).The two groups had different degrees of the damage in liver,and damage of PBC group was more serious.When compared with AIH group,the level of albumin in PBC group was significantly lower(P<0.05),and the level of globulin was significantly higher(P<0.05).In addition,the ratio of albumin/globulin in PBC group was lower than AIH group,and there was significant statistical differences(P<0.01).For the other indexes of liver function,the levels of glutamicpyruvic transaminase(ALT)were significantly higher than PBC group respectively(P<0.05),while the levels of cholestasis indicators,such as ?-glutamyl transferase(?-GT),alkaline phosphatase were higher than AIH group,and there were significant statistical differences(P<0.05).Similarly with other autoimmune diseases,the serum complement C3 level would decline and the serum immunoglobulin(Ig)level increase.Among the different kinds of immunoglobulin,the positive rates of Ig G,Ig M is significantly higher in PBC patients when compared with AIH group.The positive rate of M2 subtype of anti-mitochondrial antibody(AMA-M2)in PBC was 63.16%,while the positive rate of antinuclear antibody(ANA)in AIH was 69.70%.And the the liver damage degree was more serious in group which ANA positive expression than the negative expression one.The imaging findings of AILD were untypical,the main performances were liver damage,liver cirrhosis,splenomegaly,ascites.AIH patients occurred more commonly with chronic liver damage,and the proportion of liver cirrhosis was significantly higher in PBC patients than AIH group(P<0.05).Similarly,the phenomenon of lymphocytes-Plasma cell infiltration in portal,hepatic fibrosis or liver cirrhosis could be seen in the two groups,while the significant pathological changes of AIH were interface hepatitis,and the changes of PBC were hepatocellular cholestasis.Conclusion: There were many similarities between the patients of AIH and PBC,and patients of PBC were more serious in our study.AILD patients used to appear mostly in50-60 years old women,who usually concealed onset and lacked of typical symptoms.The white blood cell,red blood cell and platelets of PBC group were significantly lower than the numbers of AIH group respectively(P<0.05),and the liver damage of PBC group was more serious.Besides,The positive rates of Ig G,Ig M is significantly higher in PBC patients when compared with AIH group.While the significant pathological changes of AIH were interface hepatitis,and the changes of PBC were hepatocellular cholestasis.In order to diagnose and antidiastole the two diseases,we should combine the general condition and multiple tests of suspicious patients.