Spectrum of autoimmune liver diseases in western India.
OBJECTIVE
The prevalence and spectrum of autoimmune liver diseases (AILDs) in India are rarely reported in comparison to the West.


METHODS
During a study period of 7 years, all patients with chronic liver diseases (CLDs) were evaluated for the presence of AILDs on the basis of clinical, biochemical, imaging, serological, and histological characteristics.


RESULTS
Of a total of 1760 CLD patients (38.1% females), 102 patients (5.7%) had an AILD. A total of 75 (11.2%) female patients had an AILD. Among males, 27 (2.4%) had an AILD. The prevalence of AILDs in women increased from 11.2% to 45.7% and in men from 2.4% to 10.3%, after excluding alcohol, hepatitis B virus, and hepatitis C virus as a cause of CLD. Of the AILDs, autoimmune hepatitis (AIH) was present in 79 patients (77.4%), followed in descending order by primary biliary cirrhosis (PBC) in 10 patients (9.8%), PBC/AIH true overlap syndrome in six patients (5.8%), primary sclerosing cholangitis (PSC) in five patients (4.9%), and PBC/AIH switchover syndrome in two patients (1.9%). None had PSC/AIH or PBC/PSC overlap syndrome. Associated known autoimmune diseases were found in 40 (39.2%) patients.


CONCLUSIONS
AILDs are not uncommon in India. They should be suspected in all cases of CLDs, especially in middle-aged women who do not have problems with alcoholism and who are without viral etiology, as well as in all patients with known autoimmune diseases.
Amarapurkar
Deepak N
DN
Gastroenterology Department, Bombay Hospital and Medical Research Center, Mumbai, India.
Patel
Nikhil D
ND
D000328:Adult; D001327:Autoimmune Diseases / Q000453:epidemiology*; D015209:Cholangitis, Sclerosing / Q000453:epidemiology; D003710:Demography; D005260:Female; D019693:Hepatitis, Autoimmune / Q000453:epidemiology; D006801:Humans; D007194:India / Q000453:epidemiology; D008105:Liver Cirrhosis, Biliary / Q000453:epidemiology; D008107:Liver Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence