[Autoimmune chronic active hepatitis: anatomoclinic's study of 50 patients].
OBJECTIVE
To analyse anatomoclinic and evolutive aspects of autoimmune hepatitis (AIH) through 50 observations collected in two Internal Medicine departments in Algiers from 1998 to 2002 and to make a review of the literature.


METHODS
The study is prospective. The diagnosis of autoimmune hepatitis (AIH) is established according to the recommendations of the score of the International Autoimmune Hepatitis Group (1991) or/and hepatitic damage confirmed by histology.


RESULTS
Fifty patients were studied: (32 women-18 men) and the mean age was 38 years (17 to 73). Autoimmune extra-hepatitic manifestations were associated in 26%. The AIH type 1 has been noted in 58%. AIH were type 2 in only 6%. In 22% of the cases AIH were sero-negative and the others AIH represented 14% were classed as overlap-syndrome (5 cases of primary biliary cirrhosis and 2 cases of primary sclerosing cholangitis hepatitis overlap syndrome). The first liver biopsy tissue showed strong necrotic-inflammatory activity in 56% and cirrhosis was identified in 19 patients (38%). The treatment (azathioprine and corticosteroid) was prescribed in 37 patients (74%) in active chronic hepatitis or in compensed cirrhosis.


RESULTS
28% of the patients died (9-36 months) because cirrhosis's complications or because complications of hepatocarcinoma (3 cases).


CONCLUSIONS
The diagnosis of AIH must be established early for each patient with chronic liver disease particularly is those are supposed as a crypto genetic hepatitis. The prognosis is compromised by delayed diagnosis and the mortality in middle following up is high.
Hakem
D
D
Service de médecine interne, hôpital Lamine-Debaghine, CHU Bab-El-Oued, boulevard Said-Touati, Bab. El. Oued, 16009 Alger, Algérie. dj@yahoo.fr
Berrah
A
A
Berkane
S
S
Asselah
H
H
Aït-Younes
S
S
Asselah
F
F
Salah
S
S
Merriche
S
S
Abbadi
M C
MC
D000293:Adolescent; D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology*; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006521:Hepatitis, Chronic / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011379:Prognosis; D011446:Prospective Studies