title: Autoimmune hepatitis in a Jamaican cohort spanning 40 years.
abstract: BACKGROUND
  The prevalence and characteristics of autoimmune hepatitis (AIH) in black populations are not well documented.
  
  
  OBJECTIVE
  To describe the clinical and laboratory features of AIH in patients presenting at a Jamaican hospital, 1969-2009.
  
  
  METHODS
  A retrospective review of hospital records was done and patients were classified by the revised international scoring system.
  
  
  RESULTS
  Fifty patients satisfied criteria for diagnosis of AIH type-1 and most presented late at hospital. Almost one third of cases presented with chronic liver disease (32%) while 8% presented with fulminant hepatic failure and 2% with acute liver disease. Jaundice (92%) was the most common presenting feature. Other associated autoimmune diseases (10%) systemic lupus erythematosus and insulin dependent diabetes mellitus, were found. All patients (100%) had abnormal liver biochemical tests, 81% had hypergammaglobulinaemia and 82% AIH associated autoantibodies. The prevalence of autoantibodies increased with age (P=0.05). Liver biopsy, performed in 33 cases, showed chronic hepatitis (45%), cirrhosis (24%) chronic hepatitis with bridging necrosis (15%), chronic hepatitis with rosetting (6%) and nonspecific findings (10%). Patients were treated with prednisone with or without azathioprine. Relapse occurred in 4% and death 6%.
  
  
  CONCLUSIONS
  Autoimmune hepatitis is rare in Jamaicans and prognosis is similar to that reported in developed countries.
authors: Departments of Microbiology, The University of the West Indies, Mona, Jamaica, West Indies.
authors: Karen
authors: K
authors: Roye-Green
authors: Departments of Microbiology, The University of the West Indies, Mona, Jamaica, West Indies.
authors: Rohan
authors: R
authors: Willis
authors: Departments of Microbiology, The University of the West Indies, Mona, Jamaica, West Indies.
authors: Nathlee
authors: N
authors: Mc Morris
authors: Departments of Microbiology, The University of the West Indies, Mona, Jamaica, West Indies.
authors: Jacqueline
authors: J
authors: Dawson
authors: Departments of Medicine, The University of the West Indies, Mona, Jamaica, West Indies.
authors: Dwight
authors: D
authors: Whittle
authors: Departments of Medicine, The University of the West Indies, Mona, Jamaica, West Indies.
authors: Everard
authors: E
authors: Barton
authors: Departments of Microbiology, The University of the West Indies, Mona, Jamaica, West Indies.
authors: Monica
authors: M
authors: Smikle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000276:immunology; D001323:Autoantibodies / Q000276:immunology; D001327:Autoimmune Diseases / Q000453:epidemiology / Q000276:immunology / Q000473:pathology; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D019693:Hepatitis, Autoimmune / Q000453:epidemiology* / Q000276:immunology* / Q000473:pathology; D006521:Hepatitis, Chronic / Q000453:epidemiology / Q000473:pathology; D006761:Hospitals; D006801:Humans; D007223:Infant; D007563:Jamaica / Q000453:epidemiology; D008099:Liver / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000974:Antibodies, Antinuclear; D001323:Autoantibodies
keywords: Autoimmune hepatitis; Jamaica; antinuclear antibodies; scoring system; smooth muscle antibodies