Ghazanfar Haider, Sosa Franklin, Reina Raul, Altaf Faryal, Kandhi Sameer, Jyala Abhilasha, Lajara Priscilla, Balar Bhavna
Internal Medicine, Bronxcare Health System, New York, USA.
Internal Medicine, BronxCare Health System, New York, USA.
Cureus. 2025 Mar 24;17(3):e81082. doi: 10.7759/cureus.81082. eCollection 2025 Mar.
Background Autoimmune hepatitis (AIH) is a chronic inflammatory condition that can progress to liver cirrhosis. Genetics, immune system dysfunctions, and environmental factors influence the global prevalence of AIH. AIH exhibits variable clinical outcomes across ethnic groups, with Hispanic patients having a higher prevalence of cirrhosis, whereas African American patients are noted to have higher hospitalization and mortality rates. Aim The purpose of our study is to assess the clinical course of autoimmune hepatitis, specifically in Hispanic and African American patients. Methodology We performed a retrospective chart review of patients diagnosed with AIH and managed by the Gastroenterology Service from July 2006 to June 2023. The study population comprised individuals who were either Hispanic or African American and aged 18 years or older. Patients who were hospitalized and did not continue with outpatient follow-up were excluded from the analysis. Results Out of the 30 patients in our study, 27 (90%) were female and 3 (10%) were male. About 21 (70%) of the patients were Hispanic, while 9 (30%) were African American. The mean age at the time of AIH diagnosis was 45 years. Liver cirrhosis was confirmed with liver biopsy in 21 (70%) of the patients, and by imaging or clinical findings alone in an additional 3 (10%). Concomitant autoimmune diseases were present in 7 (23%) of the patients. Approximately 11 (36%) of the patients required hospitalization due to decompensated liver cirrhosis. About 19 (63%) were initially referred to the gastroenterology service due to abnormal liver function tests and were asymptomatic at the time of the first visit. About 6 (20%) of the patients presented with abdominal pain as their initial symptom. One patient had nausea and vomiting, two presented with jaundice, and one presented with altered mental status. Notably, none of the patients died during the study period. Conclusion Our study indicates that AIH is more prevalent among female and Hispanic patients as compared to male and African American patients. A significant proportion of our patients developed cirrhosis. Further studies are necessary to improve outcomes of autoimmune hepatitis in African American and Hispanic populations.
自身免疫性肝炎(AIH)是一种慢性炎症性疾病,可发展为肝硬化。遗传因素、免疫系统功能障碍和环境因素影响着AIH的全球患病率。AIH在不同种族群体中表现出不同的临床结局,西班牙裔患者肝硬化患病率较高,而非洲裔美国患者的住院率和死亡率较高。
我们研究的目的是评估自身免疫性肝炎的临床病程,特别是在西班牙裔和非洲裔美国患者中的情况。
我们对2006年7月至2023年6月期间由胃肠病科诊断并管理的AIH患者进行了回顾性病历审查。研究人群包括西班牙裔或非洲裔美国且年龄在18岁及以上的个体。住院且未继续门诊随访的患者被排除在分析之外。
在我们研究的30例患者中,27例(90%)为女性,3例(10%)为男性。约21例(70%)患者为西班牙裔,9例(30%)为非洲裔美国人。AIH诊断时的平均年龄为45岁。21例(70%)患者经肝活检确诊为肝硬化,另外3例(10%)仅通过影像学或临床检查确诊。7例(23%)患者伴有自身免疫性疾病。约11例(36%)患者因失代偿期肝硬化需要住院治疗。约19例(63%)患者最初因肝功能检查异常转诊至胃肠病科,初诊时无症状。约6例(20%)患者以腹痛为首发症状。1例患者有恶心呕吐,2例出现黄疸,1例出现精神状态改变。值得注意的是,研究期间无患者死亡。
我们的研究表明,与男性和非洲裔美国患者相比,AIH在女性和西班牙裔患者中更为普遍。我们的患者中有很大一部分发展为肝硬化。有必要进行进一步研究以改善非洲裔美国人和西班牙裔人群自身免疫性肝炎的治疗效果。