Manifestaciones clínicas y paraclínicas de la hepatitis autoinmune en 48 pacientes de la ciudad de Medellín, 1980-2004

Objective: To describe the clinical, biochemical, histological, sociodemographical and therapeutic aspects of patients with autoimmune hepatitis (AIH). Methods: Descriptive, retrospective, case series trial in 48 patients from the city of Medellín with a diagnosis of AIH according to the criteria from the International Autoimmune Hepatitis Group. Results: Average age at the time of diagnosis was 34 years, 83.3% were females. The most frequent clinical findings were fatigue (89.6%) and jaundice (81.3%). The pretreatment median of laboratory findings were: AST 626 U/L, ALT 547.5 U/L, total bilirubin 5.64 mg/dL, direct bilirubin 3.4 mg/dL. Posttreatment median values were: AST 40.5 U/L, ALT 44.4 U/L, total bilirubin 1.1 mg/dL, direct bilirubin 0.4 mg/dL (p <0.000). The average value of the gammaglobulins was 2.2 g/dL; in 81.3% of the patients a liver biopsy was performed and 97.4% of them had histological findings consistent with AIH. Forty patients had positive antinuclear antibodies. In 19 patients concurrent autoimmune diseases were found, most frequently thyroiditis. The most frequently administered treatment was the combination of prednisone plus azathioprine in 56.3% of the cases; 85.4% of the patients entered in remission and 25% had a relapse. Conclusions: The sociodemographical characteristics of our patients differ from those of other series The clinical, biochemical and histological findings are similar to those reported in the medical literature; however, this was not observed with the associated autoimmune diseases. Most patients belonged to the subtype 1 of the disease.