Autoimmune hepatitis: a study of 50 patients.
BACKGROUND
Autoimmune hepatitis (AIH) is a well-defined entity in the West but there are sparse Indian data on this disease.


OBJECTIVE
To study the clinical profile and response to treatment of Indian patients with AIH.


METHODS
This is a part retrospective and part prospective study of 50 patients (median age 48 years, range 11-82; 43 women) seen between 1995 to 2001, diagnosed to have AIH as per the revised scoring system. Clinical and laboratory profile, response to treatment, and complications of treatment were analyzed.


RESULTS
AIH accounted for 6% of all patients with liver disease seen during the period. The presenting symptoms were gastrointestinal in 43 and non-gastrointestinal in 7, with median symptom duration of 6 months (range 2 weeks to 40 years). Forty patients (80%) had chronic liver disease. Associated illnesses were present in 28 patients. Twenty-six patients were classified as definite and the rest as probable AIH. Forty-nine patients had Type 1 AIH. Five patients had overlap syndrome. Forty-five patients (90%) received immunosuppressive therapy. Twelve of 18 patients receiving only prednisolone and 21 of 27 patients receiving prednisolone and azathioprine combination responded. Thirteen (26%) patients had therapy-related complications (infectious 5, non infectious 8) with two treatment-related deaths.


CONCLUSIONS
Type 1 AIH was the predominant type of AIH. The majority of patients with AIH presented with chronic liver disease. There was good response to immunosuppressive therapy. Therapy-related complications occurred in one-fourth of patients.
Gohar
Sandeep
S
Department of Medicine, P D Hinduja National Hospital and Medical Research Center, Mumbai 400 016.
Desai
Devendra
D
Joshi
Anand
A
Bhaduri
Anita
A
Deshpande
Ramesh
R
Balkrishna
C
C
Chawla
Mukesh
M
Rodrigues
Camila
C
Joshi
V R
VR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000276:immunology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D019693:Hepatitis, Autoimmune / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007194:India / Q000453:epidemiology; D008099:Liver / Q000276:immunology / Q000473:pathology; D008105:Liver Cirrhosis, Biliary / Q000188:drug therapy / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies
D000906:Antibodies; D007166:Immunosuppressive Agents