Autoimmune Hepatitis Prevalence among Patients from Saudi Arabia with Chronic Liver Disease Referred for Transient Elastography

Rajaa Alshanketi, Reem Jabbad, B. Baghlaf, Romaysaa Al-Yamani, Majed A Al-Sahafi, Hisham O Akbar, H. Fallatah
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Abstract

Background and study aim: Autoimmune hepatitis (AIH) is a chronic liver disease that can lead to progressive liver damage. The prevalence of AIH among the general population and among chronic liver disease (CLD) patients is variable worldwide. Currently, no published data on the prevalence of AIH among Saudi or among liver disease patients from the region. In this study, we aimed to assess the prevalence of AIH among CLD patients who were referred for transient elastography (FibroScan) in Saudi Arabia. Patients and methods: A retrospective study was conducted among CLD patients who had a transient elastography (FibroScan) during the 3-year study period. We obtained demographic data and test results for serum alanine aminotransferase (ALT), bilirubin, hemoglobin (Hgb), platelets, and international normalized ratio (INR) from all patients. We compared the results of the AIH patients to those of the non-AIH patients with CLD. In addition, for AIH patients, we measured serum immunoglobulin G (IgG), antinuclear antibody (ANA), smooth muscle antibody (SMA) and ALT at 2 - 6 weeks and at 3 - 4 months. Results: We included 494 patients, who were predominantly female (271 (60%)) and Saudi (299 (60.5%)). Thirty patients (6.1%) had AIH, which represented the 4th most common liver disease. Compared to non-AIH patients, AIH patients were younger (mean ages 49.9 years, SD 14.22 years, and 40.4 years, SD 13.94 years, respectively, P = 0.001). Patients with AIH had significantly lower Hgb and platelets (P = 0.008 for both) and higher ALT, bilirubin and INR (P = 0.05, 0.047 and 0.019, respectively). More than 50% of the AIH patients had cirrhosis. Older age was not associated with advanced disease stage among the AIH patients (P th most common cause of CLD in patients referred for transient elastography in Saudi Arabia. AIH tends to be severe in patients at a young age, with a marked biochemical response to steroids and azathioprine treatment.
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沙特阿拉伯慢性肝病患者的自身免疫性肝炎患病率进行瞬时弹性成像
背景与研究目的:自身免疫性肝炎(AIH)是一种慢性肝脏疾病,可导致进行性肝损害。AIH在普通人群和慢性肝病(CLD)患者中的患病率在世界范围内是可变的。目前,没有公布的关于沙特阿拉伯或该地区肝病患者中AIH患病率的数据。在这项研究中,我们旨在评估沙特阿拉伯转介进行瞬时弹性成像(FibroScan)的CLD患者中AIH的患病率。患者和方法:在为期3年的研究期间,对进行过短暂弹性成像(FibroScan)的CLD患者进行了回顾性研究。我们获得了所有患者的人口统计学数据和血清丙氨酸转氨酶(ALT)、胆红素、血红蛋白(Hgb)、血小板和国际标准化比率(INR)的检测结果。我们比较了AIH患者与非AIH CLD患者的结果。此外,对于AIH患者,我们在2 - 6周和3 - 4个月时检测血清免疫球蛋白G (IgG)、抗核抗体(ANA)、平滑肌抗体(SMA)和ALT。结果:我们纳入了494例患者,主要是女性(271(60%))和沙特(299(60.5%))。30例患者(6.1%)患有AIH, AIH是第四大常见肝脏疾病。与非AIH患者相比,AIH患者更年轻(平均年龄49.9岁,SD 14.22岁;平均年龄40.4岁,SD 13.94岁,P = 0.001)。AIH患者Hgb和血小板均显著降低(P = 0.008), ALT、胆红素和INR均显著升高(P分别= 0.05、0.047和0.019)。超过50%的AIH患者有肝硬化。在沙特阿拉伯接受短暂弹性成像的AIH患者中,年龄较大与疾病晚期无关(AIH是CLD的最常见原因)。AIH在年轻患者中往往是严重的,对类固醇和硫唑嘌呤治疗有明显的生化反应。
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