RESUMO
BACKGROUND: The prevalence and characteristics of autoimmune hepatitis (AIH) in black populations are not well documented. OBJECTIVES: To describe the clinical and laboratory features of AIH in patients presenting at a Jamaican hospital, 1969-2009. METHODS: A retrospective review of hospital records was done and patients were classified by the revised international scoring system. RESULTS: Fifty patients satisfied criteria for diagnosis of AIH type-1 and most presented late at hospital. Almost one third of cases presented with chronic liver disease (32%) while 8% presented with fulminant hepatic failure and 2% with acute liver disease. Jaundice (92%) was the most common presenting feature. Other associated autoimmune diseases (10%) systemic lupus erythematosus and insulin dependent diabetes mellitus, were found. All patients (100%) had abnormal liver biochemical tests, 81% had hypergammaglobulinaemia and 82% AIH associated autoantibodies. The prevalence of autoantibodies increased with age (P=0.05). Liver biopsy, performed in 33 cases, showed chronic hepatitis (45%), cirrhosis (24%) chronic hepatitis with bridging necrosis (15%), chronic hepatitis with rosetting (6%) and nonspecific findings (10%). Patients were treated with prednisone with or without azathioprine. Relapse occurred in 4% and death 6%. CONCLUSION: Autoimmune hepatitis is rare in Jamaicans and prognosis is similar to that reported in developed countries.
Assuntos
Hepatite Autoimune/epidemiologia , Hepatite Autoimune/imunologia , Adolescente , Adulto , Idoso , Anticorpos Antinucleares/imunologia , Autoanticorpos/imunologia , Doenças Autoimunes/epidemiologia , Doenças Autoimunes/imunologia , Doenças Autoimunes/patologia , Biópsia , Criança , Pré-Escolar , Feminino , Hepatite Autoimune/patologia , Hepatite Crônica/epidemiologia , Hepatite Crônica/patologia , Hospitais , Humanos , Lactente , Jamaica/epidemiologia , Fígado/patologia , Lúpus Eritematoso Sistêmico/epidemiologia , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/patologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Adulto JovemRESUMO
Formalin-fixed intestinal tissue specimens from 12 Mexican pediatric patients with intussusception were examined for the presence of adenovirus. Four patients (33%) had detectable adenovirus antigen in epithelial cells as determined by using immunohistochemical analysis. Two of the patients with positive immunohistochemical results had antigens in dendritic and mononuclear inflammatory cells, and 3 patients had positive results for species C adenovirus by in situ hybridization using adenovirus species-specific probes (A-F). A real-time polymerase chain reaction assay specific for species C (nonenteric) adenoviruses was used to confirm immunohistochemical results and to amplify adenovirus DNA for sequencing. A sequence similar to that for adenovirus serotype 1 was found in 1 patient, serotype 2 in another, and serotype 6 in a third; in the fourth patient, the sequence was indeterminate between serotypes 2 and 6. The assays used in this study proved useful for the identification of species C adenoviruses in formalin-fixed specimens from Mexican pediatric patients with intussusception.