Affiliations: [a] Departments of Microbiology, The University of the West Indies, Mona, Jamaica, West Indies | [b] Departments of Medicine, The University of the West Indies, Mona, Jamaica, West Indies
Correspondence:
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Corresponding author: Karen Roye-Green, Microbiology Department, The University of the West Indies, Mona, Kingston 7, Jamaica, West Indies. Tel.: 876 9772206; Fax: 876 977 9553; E-mail: [email protected]
Abstract: 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, 1969âĂŞ2009. 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.
