Clinical Features Of Autoimmune Hepatitis

Objective Investigate the clinical, laboratory, and histologic features ofautoimmune hepatitis (AIH) and provide some guidance for its diagnosis and therapy.Methods According to the revised criteria for diagnosis of autoimmunehepatitis proposed by the International Autoimmune Hepatitis Group, 53 cases ofpatients with AIH from 1995～2007 in Peking Union Medical College hospital wereselected and retrospectively analyzed.Results 79% of patients are women, and the female to male ratio is 3.8. In allpatients, 46 cases are TypeⅠAIH, 1 case is TypeⅢAIH, 6 cases are AIH/primarybiliary cirrhosis (PBC) overlap syndrome, 1 case is AIH/ primary sclerosingcholangitis (PSC) overlap syndrome. The main clinical manifestations are jaundice,anorexia, abdominal distension and so on. 58.5% of patients suffered from the concur-rent other kind autoimmune diseases. The Laboratory test is characterized byincreased ALT, AST, IgG andγglobulin. The incidence of antinuclear antibodies(ANA) and smooth muscle antibodies (SMA) are 78.2 % and 67.4% in TypeⅠAIH.Although clinical features, serum aminotransferase, bilirubin and IgG levels of 6 casesof AIH/PBC overlap syndrome are almost as the same as TypeⅠ/ⅢAIH, serum GGT,ALP and IgM are markedly elevated in the patients with AIH/PBC overlap syndrome,accompanied with the higher incidence of mitochondrial antibodies (AMA) orAMA-M2. Only 32.1% patients received liver biopsy examination in PUMC hospitaland 9.4% of them gained histological diagnosis of AIH. The main feature ofhistologic changes is interface hepatitis. According to the criteria proposed by theIAIHG, most patients have complete response to immunosuppressive therapy.Conclusions Although clinical features of AIH are complex, but there are stillsome special characters. The diagnosis must be based on the presence of a constellation of characteristic clinical, laboratory, and histologic features. AIH/PBCoverlap syndrome have some characters of AIH and PBC separately.