Objective: To study the clinical and histologic characteristics of autoimmune hepatopathy, and to explore the diagnostic criteria and therapy.
Methods: Sixty-two patients with autoimmune hepatopathy were studied between 1996 and 1998 to compare primary biliary cirrhosis (PBC) and autoimmune hepatitis (AIH) in the clinical symptoms, signs, laboratory findings and histologic features.
Results: PBC was 59.68% and AIH 40.32% in the autoimmune hepatopathy. The morbidity in middle and old aged female patients with autoimmune hepatopathy was 83.8%. The ratio of male and female was 1:10. Whereas, the ratio of male and female was 1:5 in AIH patients and average age was 35 years old. Seropositive autoimmune antibodies were detected in 53 serum sample (PBC 85.29%; AIH 78.95%). Positive rates of the mitochondrial antibody and subtype-M2 were 100% for PBC. IgM increasing was 80% in PBC (P<0.05) and 82.35% in AIH (P<0.025). Histologic features in PBC group consisted of cholangitis, destruction or proliferation of the bile duct and inflammation within the portal tract; while in AIH group inflammation, necrosis and fibrosis of periportal region, the aggregation of lymphocytes, mononuclear cells and plasma cells in the portal tract or periportal area were found.
Conclusions: PBC and AIH are the most common two types in the patients with autoimmune hepatopathy. AIH-I is more often seen clinically. AMA-M2 is the special autoimmune antibody of PBC. The efficacy of prednisolone is better for AIH than PBC.