The features of our autoimmune hepatitis patients

Purpose: Autoımmune hepatitis (AIH); It is a liver disease of unknown etiology, diagnosed by high liver enzyme levels, high serum ımmunoglobulin levels, usually high titer autoantibodies, typical histology and exclusion of other liver diseases. In the literature, lupoid hepatitis has been named in various different ways, such as plasma cell hepatitis and autoimmune chronic active hepatitis. The disease may start with the acute hepatitis clinic or progress to cirrhosis while progressing in the form of chronic liver disease. In this study, we aimed to investigate the demographic, clinical features, laboratory parameters, treatments and treatment responses of patients diagnosed with AIH in our clinic at the time of diagnosis and compare them with the literature data. Method: In this study, the data of 62 patients who were diagnosed with AIH in Dicle University Medical Faculty hospital between January 1, 2010 and January 20, 2020 were retrospectively analyzed. General characteristics of the patients at the time of diagnosis, laboratory values, autoantibody levels, presence of additional autoimmune diseases, liver histology, treatment status and treatment responses, mean follow-up time, mean and median survival times were investigated. Results: 57 (91.9%) of the patients were female and 5 (8.1%) were male. The female / male ratio was found to be 11.4 / 1. The average age of the patients included in the study was 34.76 ± 14.9, while the median age was 35.5 (4-69). Average follow-up time of patients was 31.4 months (± 24) and median follow-up was 24 months (1-60). Type 1 AIH was found as 61.2%, Type 2 AIH as 5%, overlap syndromes as 12.8% and cryptogenic chronic hepatitis as 21%. It was observed that type 1 variant was seen most frequently in the classification of AIH and the frequency of cryptogenic chronic hepatitis should not be ignored. The most common ANA (71.6%) from autoantibodies was positive. When we look at other autoimmune diseases that accompany autoimmune hepatitis patients, autoimmune thyroiditis was the most common concomitant disease (11.3%). The number of patients with lower and / or subordinate 10-fold increased was 34 (54.8%).A 10-fold increase in aminotransferase levels was more common in women. It was statistically significant. (p<0,05). Histologically, Interface hepatitis was 100%, lymphoplasmocytic infiltration was 59.5%, and rosette formation was 19.4%. In addition, biliary changes were seen to accompany 22.6%. At the time of diagnosis, 19 (30.6%) patients had liver cirrhosis, which indicates that the diagnosis of AIH should come to mind in the patient presenting with liver cirrhosis. While 58% (36) of the patients given treatment responded completely, 22.5% (14) gave partial response, 9.6% (6) were unresponsive. The mean time to complete remission of patients with complete response was 11.78 months on average. Relapses were observed in 22 (61%) of 36 patients with complete responses. When we look at the enzyme, bilirubin and IgG follow-up of the patients, decreases were detected from the first month of treatment. There was a significant decrease in lower, subordinate, alpine and IgG at the end of the first month, while a significant decrease in total bilirubin was detected at the end of the third month. (p<0,05).It was determined that the patients with definitive and probable diagnosis before and after treatment turned into each other statistically. Before and after the treatment, it was determined that the patients with definite and probable diagnosis turned into each other in a statistically significant way. (p<0,05). It was determined that 2 (3.2%) of the patients included in the study were not alive and 60 (96.8%) were alive. The mean survival time of patients was 105 months (standard deviation: 2.1; CI: 101.5-110). Median survival time not reached. The 5-year survival rate of patients was 92%. Conclusion: AIH is essentially a diagnosis of exclusion, more common in women. The prevalence of female dominance in our study was consistent with the literature. Frequency of type 1 AIH, presence of ANA as an autoantibody and rates of liver cirrhosis in diagnosis were found to be compatible with the literature. In fact, autoimmune hepatitis should be considered in the etiology of the patient who comes with impaired liver function tests. Because AIH responds well to treatment and AIH patients can be followed in remission for a long time with treatment. Key words: Autoımmune hepatitis, ANA, cirrhosis