دورية أكاديمية
أعرض في EDS

Diagnosis and Treatment of Autoimmune Liver Diseases in a Tertiary Referral Center in Cuba.

التفاصيل البيبلوغرافية
العنوان: Diagnosis and Treatment of Autoimmune Liver Diseases in a Tertiary Referral Center in Cuba.
المؤلفون: Fernández MIC; Department of Researches, National Institute of Gastroenterology, Havana, Cuba., Hernández DR; Department of Immunology, National Institute of Gastroenterology, Havana, Cuba., Cabrera Eugenio DE; Department of Researches, National Institute of Gastroenterology, Havana, Cuba., Palanca W; Department of Researches, National Institute of Gastroenterology, Havana, Cuba., Guridi ZD; Department of Hepatology, National Institute of Gastroenterology, Havana, Cuba., González Fabián L; Department of Pathology, National Institute of Gastroenterology, Havana, Cuba.
المصدر: Current therapeutic research, clinical and experimental [Curr Ther Res Clin Exp] 2017 Apr 07; Vol. 85, pp. 8-14. Date of Electronic Publication: 2017 Apr 07 (Print Publication: 2017).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0372621 Publication Model: eCollection Cited Medium: Print ISSN: 0011-393X (Print) Linking ISSN: 0011393X NLM ISO Abbreviation: Curr Ther Res Clin Exp Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: New York Ny : Excerpta Medica
مستخلص: Background: Autoimmune liver diseases (AILD) comprise a set of entities characterized by tissue damage as a result of the loss of self-tolerance. There are few reports of AILD from Caribbean countries.
Objectives: The aim of our study was to investigate the clinical patterns, laboratory findings, and immunologic features, treatment responses, and prognoses of AILD in adult patients at a Cuban tertiary referral center.
Methods: A prospective study was conducted at the National Institute of Gastroenterology in Havana, Cuba, from May 2012 to April 2016. Clinical, immunologic, and histologic features of autoimmune hepatitis (AIH), primary biliary cirrhosis, AIH/primary biliary cirrhosis overlap syndrome, autoimmune cholangiopathy, and primary sclerosing cholangitis were recorded. Response to therapy was assessed by serum alanine aminotransferase and bilirubin levels at 3, 6, 12, and 24 months after treatment initiation.
Results: Of the 106 patients included in the study, 85.5% were women. The median age at presentation was 47 years. AIH was the most common AILD and was diagnosed in 60 patients (56.6%), 55 of whom had type 1 AIH. Primary biliary cirrhosis was diagnosed in 22 patients (20.7%), overlap syndrome in 16 patients (15%), autoimmune cholangiopathy in 5 patients (4.71%), and PSC in 3 patients (2.8%). Most patients were symptomatic; 48 patients (45.2%) presented with liver cirrhosis, 14.5% of whom had decompensated cirrhosis. Follow-up of treatment was between 6 and 24 months. Prednisone monotherapy was used in 22 AIH patients (36.6%) and a combination of prednisone and azathioprine was used in 28 (46.6%) AIH patients. Response to treatment was seen in 41 AIH patients (68.3%), 33 of whom (55%) had a complete response and 8 of whom (24.2%) relapsed after 12 months of maintenance therapy. No or incomplete response to treatment was seen in 18 patients (30%). In 46 patients with autoimmune cholestasis, ursodeoxycholic acid was used as monotherapy in 25 patients (54.3%).
Conclusions: The clinical profile of AILD in a sample of the Cuban population is similar to that reported in South areas (Developing countries). AIH was more frequent than PBC, and usually presented with advanced liver disease that responded poorly to treatment.
References: World J Gastroenterol. 2010 Feb 28;16(8):934-47. (PMID: 20180231)
Can J Gastroenterol. 2013 Jul;27(7):417-23. (PMID: 23862175)
Expert Rev Gastroenterol Hepatol. 2013 May;7(4):365-85. (PMID: 23639095)
J Hepatol. 1999 Mar;30(3):394-401. (PMID: 10190720)
J Autoimmun. 2010 May;34(3):J300-6. (PMID: 20036105)
Hepatology. 2010 Jun;51(6):2193-213. (PMID: 20513004)
World J Gastroenterol. 2013 Jun 21;19(23):3629-33. (PMID: 23801865)
J Clin Gastroenterol. 2010 Mar;44(3):208-13. (PMID: 20087196)
N Engl J Med. 2006 Jan 5;354(1):54-66. (PMID: 16394302)
Minerva Gastroenterol Dietol. 2005 Dec;51(4):313-33. (PMID: 16282960)
Transplant Proc. 2006 Oct;38(8):2473-4. (PMID: 17097971)
Hepatology. 1999 Dec;30(6):1381-6. (PMID: 10573515)
Hepatology. 2009 Mar;49(3):1017-44. (PMID: 19243014)
Aliment Pharmacol Ther. 2012 Oct;36(8):691-707. (PMID: 22973822)
J Clin Med Res. 2013 Aug;5(4):281-5. (PMID: 23864917)
Hepatology. 2006 Mar;43(3):532-8. (PMID: 16496338)
Hepatology. 2009 Jul;50(1):291-308. (PMID: 19554543)
J Gastroenterol Hepatol. 2001 Oct;16(10):1144-8. (PMID: 11686842)
Saudi J Gastroenterol. 2010 Apr-Jun;16(2):95-9. (PMID: 20339178)
J Gastroenterol Hepatol. 1998 May;13(5):490-5. (PMID: 9641646)
Frontline Gastroenterol. 2013 Jan;4(1):2-11. (PMID: 28839695)
Clin Gastroenterol Hepatol. 2011 Jan;9(1):57-63. (PMID: 20723617)
Clin Rev Allergy Immunol. 2012 Jun;42(3):288-97. (PMID: 21188646)
Eur J Gastroenterol Hepatol. 2012 May;24(5):531-4. (PMID: 22465972)
QJM. 2004 Jul;97(7):407-12. (PMID: 15208428)
World J Gastroenterol. 2008 Jun 7;14(21):3306-12. (PMID: 18528928)
Zhonghua Gan Zang Bing Za Zhi. 2008 May;16(5):367-71. (PMID: 18510851)
World J Gastroenterol. 2008 Jun 7;14(21):3396-402. (PMID: 18528937)
J Hepatol. 2010 Jul;53(1):191-8. (PMID: 20400196)
J Gastroenterol Hepatol. 2010 Oct;25(10):1681-6. (PMID: 20880179)
World J Gastroenterol. 2008 Jun 7;14(21):3313-27. (PMID: 18528929)
Clin Mol Hepatol. 2016 Jun;22(2):281-5. (PMID: 27246353)
Hepatology. 2008 Jul;48(1):169-76. (PMID: 18537184)
BMC Gastroenterol. 2005 Aug 15;5:27. (PMID: 16098234)
Ther Adv Chronic Dis. 2013 May;4(3):119-41. (PMID: 23634279)
Hepatology. 2010 Feb;51(2):660-78. (PMID: 20101749)
Hepatology. 1998 Aug;28(2):296-301. (PMID: 9695990)
فهرسة مساهمة: Keywords: Autoimmune hepatitis; Autoimmune liver diseases; Clinical patterns; Primary biliary cirrhosis; Treatment
تواريخ الأحداث: Date Created: 20171122 Latest Revision: 20220311
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC5681282
DOI: 10.1016/j.curtheres.2017.04.002
PMID: 29158853
قاعدة البيانات: MEDLINE
الوصف
تدمد:0011-393X
DOI:10.1016/j.curtheres.2017.04.002