Zahiruddin Ayesha, Farahmand Abtin, Gaglio Paul, Massoumi Hatef
Montefiore Medical Center, USA.
Albert Einstein College of Medicine, USA.
Gastroenterol Hepatol Bed Bench. 2016 Summer;9(3):225-30.
We hypothesized that AIH outcomes might be different in our patient population that consists of a large number of Latinos.
Literature has suggested that the presentation and outcome of autoimmune hepatitis can be different among different ethnicity and communities.
We performed a retrospective chart review of Latino patients with AIH diagnosed between 2002-2012. Complete and partial remissions were defined as normalization of liver enzyme values, or achieving less than twice the upper limit normal (ULN), respectively.
A total of 28 patients were identified. 26 (93%) were female. 13 (46%) had an acute presentation, one with type 2 AIH and 3 with ANA seronegative disease. The average pathologic stage (Ishak score) was 3.44±1.67 (range: 0-6). Complete and partial remission was achieved in 20 (71%) and 5 (18%) patients respectively. Ten patients (38%) required maintenance prednisone either alone (2), or in combination with Azathioprine (6) or Mycophenolate Mofetil (2). Remission in the majority of patients, including 14 (50%) who were cirrhotic. Six of 14 (43%) cirrhotic patients were asymptomatic at the time of diagnosis.
In an urban Latino population, cirrhosis was the initial presentation of AIH in a significant percentage of patients raising concerns regarding insufficient screening for AIH in this patient population. A large number of patients required continuous prednisone to avoid relapse.
我们推测，在我们由大量拉丁裔组成的患者群体中，自身免疫性肝炎（AIH）的预后可能有所不同。
文献表明，自身免疫性肝炎的表现和预后在不同种族和社区之间可能存在差异。
我们对2002年至2012年间诊断为AIH的拉丁裔患者进行了回顾性病历审查。完全缓解和部分缓解分别定义为肝酶值恢复正常，或达到正常上限（ULN）的两倍以下。
共确定了28例患者。26例（93%）为女性。13例（46%）有急性表现，1例为2型AIH，3例为抗核抗体（ANA）血清阴性疾病。平均病理分期（Ishak评分）为3.44±1.67（范围：0 - 6）。分别有20例（71%）和5例（18%）患者实现了完全缓解和部分缓解。10例患者（38%）需要单独使用泼尼松（2例），或与硫唑嘌呤（6例）或霉酚酸酯（2例）联合进行维持治疗。大多数患者实现了缓解，包括14例（50%）肝硬化患者。14例肝硬化患者中有6例（43%）在诊断时无症状。
在城市拉丁裔人群中，相当比例的患者以肝硬化作为AIH的初始表现，这引发了对该患者群体中AIH筛查不足的担忧。大量患者需要持续使用泼尼松以避免复发。
