Analysis Of Clinical Characteristics Of Autoimmune Hepatitis

Object:To study clinical characteristics of autoimmune hepatitis.Methods:It's a retrospective study,we collected data of 166 patients who were clearly diagnosed with AIH from January 2012 to January 2018 at the the First hospital of jilin university,the general information,clinical manifestation,laboratory examinations,autoimmune antibodies,,imageological examinations and histopathologic characteristics were analyzed and summarized.Result:Of all the 166 patients,134 were simple AIH patients,and 32 were AIH-PBC overlapping syndromes.Male and female proportion was 1:13,and the average age was 55.6 years.The main clinical manifestations were fatigue(63.9%),anorexia,nausea and other gastrointestinal symptoms(73.5%),jaundice(47.0%),and 14.4% of patients with extrahepatic symptoms(xerostomia,arthralgia).33.7% of patients also had other extrahepatic autoimmune diseases,of which Sjogren's syndrome was the most common.The results of liver function tests on admission were most marked with elevated ALT and AST.Patients with immunoglobulins above the upper limit of normal,elevated Ig G are the most common.95% of patients were ANA positive.There was no significant difference in ALT,AST,ALB,TBi L,DBi L,Ig G,Ig A levels between the AIH group and the AIH-PBC overlap syndrome group.The ALP,GGT,GLB and Ig M values of the AIH-PBC overlap syndrome group were significantly higher than those of the simple AIH group.The positive rate of AMA-2 and anti-GP210 antibodies in the AIH-PBC overlap syndrome group were also significantly higher than those of the AIH alone group.39.7% of patients had imaging cirrhosis.Sixty-five patients underwent liver biopsy pathology,and all showed varying degrees of liver cell degeneration,necrosis,and infiltration of lymphocytes and plasma cells in the portal area.Among which,44 patients had different degrees of fibrous tissue hyperplasia in the portal area(S1 20 cases,S2 11 cases,S3 11 cases,S42 cases),63 cases of patients with varying degrees of "interface inflammation"(mild11 cases,There were 29 cases of moderate degree and 33 cases of severe cases.35 specimens showed typical rosette-like changes,and 33 specimens showed bridging necrosis.Eighty-eight patients were treated with hormone alone or in combination with azathioprine,and the remaining 78 patients were symptomatic and supportive.Six patients had no need for immunosuppressive therapy because of low inflammation,and 14 patients were degraded due to cirrhosis.The AST values and hepatic histology in the immunosuppressive treatment group were significantly higher than those in the non-immunosuppressive treatment group.Conclusion:1.Autoimmune hepatitis occurs in middle-aged and elderly women.The AIH lack specific clinical manifestations,and some patients have already been in the cirrhosis stage when they noticed these problem.2.AIH is associated with PBC and other autoimmune diseases.There is a high proportion of AIH-PBC overlap syndrome,AIH can also combined with Sjogren's syndrome,which is the most common in extrahepatic autoimmune diseases.3.Hepatic histology suggests that hepatic inflammation in AIH patients is heavier,mostly in G3 and G4 phases,The degree of fibrosis is mostly in the S1,S2,and S3 phases.