Autoimmune hepatitis in an Internal Medicine ward
Autor(a) principal: | |
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Data de Publicação: | 2008 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://revista.spmi.pt/index.php/rpmi/article/view/1454 |
Resumo: | Introduction: Autoimmune Hepatitis (AIH) is a hepatocellular inflammation of unknown cause, characterised by the presence of interface hepatitis on liver biopsy, and hypergammaglobulinaemia and autoantibodies in serum.Objective: To characterise clinical, laboratory and histological features, as well as the outcome, of AIH.Methods - Retrospective analysis of AIH cases admitted between 1987 and 2002 in an Internal Medicine Ward.Results: Twenty nine patients (pts), with a mean age of 34.2 ±16.4 years and a male-to-female ratio 1:28. The onset was fulminant in 6.9%, acute in 20.7% and insidious or chronic in 72.4%. Asthenia (65.6%), anorexia (48.3%), nausea and vomiting (48.3%), were the most common symptoms; 24.1% were asymptomatic. Applying the scoring system of the International Autoimmune Hepatitis Group, the diagnosis was definitive in 69% and probable in 31%. HAI type I was diagnosed in 86.2%, 3.5% were type II and in 10.3% none of the standard antibodies were found. Two pts were positive for anti-VHC, 1 for HbsAg and 1 had a recent history of hepatitis A. Initial therapy was prednisolone in 13 pts and prednisolone + azathioprine in 15. Complete response was achieved in 39.3%, partial response in 7.1%, failure in 25% and relapse in 28.6%. Four patients underwent liver transplantation. During a mean follow-up period of 69 months (range, 1 to 213 months), the mortality was 13.8%: 2 pts died from hepatic failure, 1 from sepsis and 1 from herpetic meningitis.Conclusions: At the time of diagnosis, 24.1% of the patients were asymptomatic and 27.1% had cirrhosis; therapy with prednisolone and azathioprine was more effective than prednisolone monotherapy; liver transplantation was required in 4 patients; the evolution was favourable in the majority of cases. |
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Autoimmune hepatitis in an Internal Medicine wardHepatite Auto-Imune Casuística de um serviço de Medicina Internahepatite auto-imunescore do International Autoimmune Hepatitis Groupevolução clínicatratamentoautoimmune hepatitisInternational Autoimmune Hepatitis Group scoring systemclinical outcometreatmentIntroduction: Autoimmune Hepatitis (AIH) is a hepatocellular inflammation of unknown cause, characterised by the presence of interface hepatitis on liver biopsy, and hypergammaglobulinaemia and autoantibodies in serum.Objective: To characterise clinical, laboratory and histological features, as well as the outcome, of AIH.Methods - Retrospective analysis of AIH cases admitted between 1987 and 2002 in an Internal Medicine Ward.Results: Twenty nine patients (pts), with a mean age of 34.2 ±16.4 years and a male-to-female ratio 1:28. The onset was fulminant in 6.9%, acute in 20.7% and insidious or chronic in 72.4%. Asthenia (65.6%), anorexia (48.3%), nausea and vomiting (48.3%), were the most common symptoms; 24.1% were asymptomatic. Applying the scoring system of the International Autoimmune Hepatitis Group, the diagnosis was definitive in 69% and probable in 31%. HAI type I was diagnosed in 86.2%, 3.5% were type II and in 10.3% none of the standard antibodies were found. Two pts were positive for anti-VHC, 1 for HbsAg and 1 had a recent history of hepatitis A. Initial therapy was prednisolone in 13 pts and prednisolone + azathioprine in 15. Complete response was achieved in 39.3%, partial response in 7.1%, failure in 25% and relapse in 28.6%. Four patients underwent liver transplantation. During a mean follow-up period of 69 months (range, 1 to 213 months), the mortality was 13.8%: 2 pts died from hepatic failure, 1 from sepsis and 1 from herpetic meningitis.Conclusions: At the time of diagnosis, 24.1% of the patients were asymptomatic and 27.1% had cirrhosis; therapy with prednisolone and azathioprine was more effective than prednisolone monotherapy; liver transplantation was required in 4 patients; the evolution was favourable in the majority of cases.Introdução: A hepatite auto-imune (HAI) é uma inflamação hepática de causa desconhecida, caracterizada pela presença de hepatite de interface na biopsia hepática, de hipergamaglobulinemia e de auto-anticorpos característicos.Objectivo: Avaliar as características clínicas, laboratoriais e histológicas, a resposta à terapêutica e o prognóstico da hepatite auto-imune.Métodos: Análise dos processos clínicos dos doentes com hepatite auto-imune admitidos no Serviço de Medicina III dos HUC entre 1987 e 2002.Resultados – Foram diagnosticados 29 casos, 28 do sexo feminino e 1 do masculino, com a idade média de 34,2±16,4 anos. A forma de apresentação foi fulminante em 6,9% dos doentes, aguda em 20,7% e insidiosa ou crónica em 72,4%. Os sintomas mais comuns foram: astenia (65,6%), anorexia (48,3%), náuseas e vómitos (48,3%); 24,1% dos doentes eram assintomáticos. Pelo score do International Autoimmune Hepatitis Group, o diagnóstico era definitivo em 69% dos casos e provável em 31%. Tinham HAI tipo I 86,2% dos doentes, 3,5% eram do tipo II e 10,3% não apresentavam auto-anticorpos convencionais. O anti-VHC era positivo em 2 doentes, o AgHBs em 1 e o IgM anti-VHA em 1. Apresentavam cirrose 27,6% dos doentes. Treze iniciaram terapêutica com prednisolona e 15 com prednisolona + azatioprina, com resposta completa em 39,3% dos casos, parcial em 7,1%, ausência de resposta em 25% e resposta seguida de recaída em 28,6%. O transplante hepático foi realizado em 4 doentes (13,8%). Com um período médio de seguimento de 69 meses (variando entre 1 e 213 meses), a mortalidade foi de 13,8%: 2 doentes por falência hepática, 1 por sepsis e 1 por meningite herpética.Conclusões: À data do diagnóstico, 24,1% dos doentes eram assintomáticos e 27,6% tinham cirrose; a terapêutica com prednisolona e azatioprina foi mais eficaz que a prednisolona isolada; houve necessidade de transplante hepático em 13,8% dos doentes; a evolução foi favorável na maioria dos casos.Sociedade Portuguesa de Medicina Interna2008-06-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://revista.spmi.pt/index.php/rpmi/article/view/1454Internal Medicine; Vol. 15 No. 2 (2008): Abril/ Junho; 87-92Medicina Interna; Vol. 15 N.º 2 (2008): Abril/ Junho; 87-922183-99800872-671Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spmi.pt/index.php/rpmi/article/view/1454https://revista.spmi.pt/index.php/rpmi/article/view/1454/1002Vaio, TeresaFerreira, PauloSantos, ArsénioSimão, AdéliaPerdigoto, RuiSantos, RuiCarvalho, ArmandoPorto, Armandoinfo:eu-repo/semantics/openAccess2023-01-07T06:10:38Zoai:oai.revista.spmi.pt:article/1454Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:29:38.271376Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Autoimmune hepatitis in an Internal Medicine ward Hepatite Auto-Imune Casuística de um serviço de Medicina Interna |
title |
Autoimmune hepatitis in an Internal Medicine ward |
spellingShingle |
Autoimmune hepatitis in an Internal Medicine ward Vaio, Teresa hepatite auto-imune score do International Autoimmune Hepatitis Group evolução clínica tratamento autoimmune hepatitis International Autoimmune Hepatitis Group scoring system clinical outcome treatment |
title_short |
Autoimmune hepatitis in an Internal Medicine ward |
title_full |
Autoimmune hepatitis in an Internal Medicine ward |
title_fullStr |
Autoimmune hepatitis in an Internal Medicine ward |
title_full_unstemmed |
Autoimmune hepatitis in an Internal Medicine ward |
title_sort |
Autoimmune hepatitis in an Internal Medicine ward |
author |
Vaio, Teresa |
author_facet |
Vaio, Teresa Ferreira, Paulo Santos, Arsénio Simão, Adélia Perdigoto, Rui Santos, Rui Carvalho, Armando Porto, Armando |
author_role |
author |
author2 |
Ferreira, Paulo Santos, Arsénio Simão, Adélia Perdigoto, Rui Santos, Rui Carvalho, Armando Porto, Armando |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Vaio, Teresa Ferreira, Paulo Santos, Arsénio Simão, Adélia Perdigoto, Rui Santos, Rui Carvalho, Armando Porto, Armando |
dc.subject.por.fl_str_mv |
hepatite auto-imune score do International Autoimmune Hepatitis Group evolução clínica tratamento autoimmune hepatitis International Autoimmune Hepatitis Group scoring system clinical outcome treatment |
topic |
hepatite auto-imune score do International Autoimmune Hepatitis Group evolução clínica tratamento autoimmune hepatitis International Autoimmune Hepatitis Group scoring system clinical outcome treatment |
description |
Introduction: Autoimmune Hepatitis (AIH) is a hepatocellular inflammation of unknown cause, characterised by the presence of interface hepatitis on liver biopsy, and hypergammaglobulinaemia and autoantibodies in serum.Objective: To characterise clinical, laboratory and histological features, as well as the outcome, of AIH.Methods - Retrospective analysis of AIH cases admitted between 1987 and 2002 in an Internal Medicine Ward.Results: Twenty nine patients (pts), with a mean age of 34.2 ±16.4 years and a male-to-female ratio 1:28. The onset was fulminant in 6.9%, acute in 20.7% and insidious or chronic in 72.4%. Asthenia (65.6%), anorexia (48.3%), nausea and vomiting (48.3%), were the most common symptoms; 24.1% were asymptomatic. Applying the scoring system of the International Autoimmune Hepatitis Group, the diagnosis was definitive in 69% and probable in 31%. HAI type I was diagnosed in 86.2%, 3.5% were type II and in 10.3% none of the standard antibodies were found. Two pts were positive for anti-VHC, 1 for HbsAg and 1 had a recent history of hepatitis A. Initial therapy was prednisolone in 13 pts and prednisolone + azathioprine in 15. Complete response was achieved in 39.3%, partial response in 7.1%, failure in 25% and relapse in 28.6%. Four patients underwent liver transplantation. During a mean follow-up period of 69 months (range, 1 to 213 months), the mortality was 13.8%: 2 pts died from hepatic failure, 1 from sepsis and 1 from herpetic meningitis.Conclusions: At the time of diagnosis, 24.1% of the patients were asymptomatic and 27.1% had cirrhosis; therapy with prednisolone and azathioprine was more effective than prednisolone monotherapy; liver transplantation was required in 4 patients; the evolution was favourable in the majority of cases. |
publishDate |
2008 |
dc.date.none.fl_str_mv |
2008-06-30 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://revista.spmi.pt/index.php/rpmi/article/view/1454 |
url |
https://revista.spmi.pt/index.php/rpmi/article/view/1454 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revista.spmi.pt/index.php/rpmi/article/view/1454 https://revista.spmi.pt/index.php/rpmi/article/view/1454/1002 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
dc.source.none.fl_str_mv |
Internal Medicine; Vol. 15 No. 2 (2008): Abril/ Junho; 87-92 Medicina Interna; Vol. 15 N.º 2 (2008): Abril/ Junho; 87-92 2183-9980 0872-671X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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