title: Clinical features of elderly Chinese patients with autoimmune hepatitis.
abstract: OBJECTIVE
  To study the clinical features of elderly Chinese patients with autoimmune hepatitis.
  
  
  METHODS
  The clinical features of 36 patients diagnosed at age >60 years were compared with those of 39 patients aged <50 years.
  
  
  RESULTS
  The M:F ratio was 1:35 (>60 years) vs. 3:36 (<50 years). The patients >60 years had a higher frequency of cirrhosis at presentation than the patients <50 years (52.8% vs. 15.4%, p=0.001). The patients >60 years also had a significantly increased incidence of ascites at presentation (41.7% vs. 10.3%, p=0.001) and lower serum albumin levels (p=0.037). There were significant differences between older and younger patients with respect to the frequencies or titers of anti-nuclear antibody (46.2% vs. 83.3%, p=0.011). HLA DR3 positivity occurred more frequently in the patients <50 years than in those >60 years (59.0% vs. 19.4%, p<0.001), whereas HLA DR4 occurred more often in the patients >60 years (63.9% vs. 25.6%, p=0.001). Treatment failure occurred more frequently in the patients <50 years (28.2% vs. 9.1%, p=0.041). However, there were no significant differences between the groups with respect tomode of onset, other clinical signs at presentation biochemical parameters, and smooth muscle antibody positivity.
  
  
  CONCLUSIONS
  Elderly patients have a greater frequency of cirrhosis at presentation, anti-nuclear antibody, HLA DR4 positivity than patients <50 years, and they have a lower occurrence of treatment failure. Conventional corticosteroid regimens may be an effective management for older patients with autoimmune hepatitis.
authors.affiliation: Dalian Sixth People Hospital, Sixth Department of Liver Diseases, Dalian, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.forename: Wan-Li
authors.initials: WL
authors.lastname: Sun
authors.forename: De-Long
authors.initials: DL
authors.lastname: Jin
authors.forename: Du
authors.initials: D
authors.lastname: Jing-Hua
mesh_terms: D000367:Age Factors; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000974:Antibodies, Antinuclear / Q000097:blood; D001201:Ascites / Q000209:etiology*; D001379:Azathioprine / Q000627:therapeutic use; D002681:China; D005260:Female; D015803:HLA-DR3 Antigen / Q000097:blood; D015804:HLA-DR4 Antigen / Q000097:blood; D019693:Hepatitis, Autoimmune / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D017678:Sex Distribution; D017211:Treatment Failure
chemical_list: D000893:Anti-Inflammatory Agents; D000974:Antibodies, Antinuclear; D015803:HLA-DR3 Antigen; D015804:HLA-DR4 Antigen; D011239:Prednisolone; D001379:Azathioprine