Caracterización de pacientes con hepatitis autoinmune
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2022
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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La hepatitis autoinmune es una enfermedad hepática de tipo inflamatoria progresiva caracterizada por los altos niveles de aminotransferasas e inmunoglobulinas G, anticuerpos circulantes y una respuesta aceptable a ciertos tratamientos inmunosupresores. Objetivo: fue determinar las características clínicas de pacientes con hepatitis autoinmune en el hospital “Teodoro Maldonado Carbo”. Metodología: investigación retrospectiva, descriptiva y transversal en pacientes con diagnóstico de hepatitis autoinmune atendidos en los servicios de urgencia, hospitalización y consulta externa por la Unidad de Gastroenterología del hospital, entre 2014 al 2021. Resultados: Se analizaron 51 historias clínicas, de los cuales el 86, 27% fueron femenino y13,72% masculino, edad media entre 41-50 años. La forma de inicio fue aguda con presencia de elevación de enzimas hepáticas en el 41,17% mientras que el 11,8% fueron pacientes asintomáticos. Los valores paraclínicos hubo predominio de hipergammaglobulinemia, elevación de aminotransferasas, positividad de anticuerpos relacionados y una histología típica en la biopsia hepática. Se presentó como enfermedad avanzada (Cirrosis Hepática) el 31,4% de los casos. El tratamiento más usado fue la prednisona, donde la respuesta ante este tipo de tratamiento fue completa en la mayoría de casos. Conclusiones: La HAI no es una enfermedad rara en nuestro medio y al igual que en la población y estadística mundial predomina en mujeres entre quinta y sexta década de la vida, con una presentación clínica variable, asociada con cirrosis en su mayoría. Es transcendental realizar un diagnóstico oportuno y presentar un plan terapéutico eficaz que permita la remisión completa y evite la progresión de la enfermedad.
Autoimmune hepatitis is a progressive inflammatory liver disease characterized by high levels of aminotransferases and immunoglobulins G, circulating antibodies, and an acceptable response to certain immunosuppressive treatments. Objective: it was to determine the clinic characteristics of patients with autoimmune hepatitis in the "Teodoro Maldonado Carbo" hospital. Methodology: retrospective, descriptive and cross-sectional research in patients diagnosed with autoimmune hepatitis treated in the emergency, hospitalization and outpatient services by the Gastroenterology Unit of the hospital, between 2014 and 2021. Results: 51 medical records were analyzed, of which 86, 27% were female and 13.72% male, mean age between 41-50 years. The onset form was acute with the presence of elevated liver enzymes in 41.17% while 11.8% were asymptomatic patients. The paraclinical values showed a predominance of hypergammaglobulinemia, elevation of aminotransferases, positivity of related antibodies and a typical histology in the liver biopsy. 31.4% of cases presented as advanced disease (Liver Cirrhosis). The most used treatment was prednisone, where the response to this type of treatment was complete in most cases. Conclusions: HAI is not a rare disease in our environment and, as in the population and world statistics, it predominates in women between the fifth and sixth decade of life, with a variable clinical presentation, associated with cirrhosis in its majority. It is crucial to make an opportune diagnosis and present an effective therapeutic plan that allows complete remission and prevents the progression of the disease
Autoimmune hepatitis is a progressive inflammatory liver disease characterized by high levels of aminotransferases and immunoglobulins G, circulating antibodies, and an acceptable response to certain immunosuppressive treatments. Objective: it was to determine the clinic characteristics of patients with autoimmune hepatitis in the "Teodoro Maldonado Carbo" hospital. Methodology: retrospective, descriptive and cross-sectional research in patients diagnosed with autoimmune hepatitis treated in the emergency, hospitalization and outpatient services by the Gastroenterology Unit of the hospital, between 2014 and 2021. Results: 51 medical records were analyzed, of which 86, 27% were female and 13.72% male, mean age between 41-50 years. The onset form was acute with the presence of elevated liver enzymes in 41.17% while 11.8% were asymptomatic patients. The paraclinical values showed a predominance of hypergammaglobulinemia, elevation of aminotransferases, positivity of related antibodies and a typical histology in the liver biopsy. 31.4% of cases presented as advanced disease (Liver Cirrhosis). The most used treatment was prednisone, where the response to this type of treatment was complete in most cases. Conclusions: HAI is not a rare disease in our environment and, as in the population and world statistics, it predominates in women between the fifth and sixth decade of life, with a variable clinical presentation, associated with cirrhosis in its majority. It is crucial to make an opportune diagnosis and present an effective therapeutic plan that allows complete remission and prevents the progression of the disease
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HEPATITIS, ALITIPOS DE INMUNOGLOBULINAS, BIOPSIA, HOSPITAL DE ESPECIALIDADES DR. TEODORO MALDONADO CARBO, CANTON GUAYAQUIL, ECUADOR