Résumé
INTRODUCTION: Autoimmune hepatitis (AIH) is a well-defined entity in the West but there are sparse Indian data on this disease. AIM: To study the clinical profile and response to treatment of Indian patients with AIH. METHODS: This is a part retrospective and part prospective study of 50 patients (median age 48 years, range 11-82; 43 women) seen between 1995 to 2001, diagnosed to have AIH as per the revised scoring system. Clinical and laboratory profile, response to treatment, and complications of treatment were analyzed. RESULTS: AIH accounted for 6% of all patients with liver disease seen during the period. The presenting symptoms were gastrointestinal in 43 and non-gastrointestinal in 7, with median symptom duration of 6 months (range 2 weeks to 40 years). Forty patients (80%) had chronic liver disease. Associated illnesses were present in 28 patients. Twenty-six patients were classified as definite and the rest as probable AIH. Forty-nine patients had Type 1 AIH. Five patients had overlap syndrome. Forty-five patients (90%) received immunosuppressive therapy. Twelve of 18 patients receiving only prednisolone and 21 of 27 patients receiving prednisolone and azathioprine combination responded. Thirteen (26%) patients had therapy-related complications (infectious 5, non infectious 8) with two treatment-related deaths. CONCLUSION: Type 1 AIH was the predominant type of AIH. The majority of patients with AIH presented with chronic liver disease. There was good response to immunosuppressive therapy. Therapy-related complications occurred in one-fourth of patients.
Sujets)
Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Anticorps/immunologie , Enfant , Femelle , Études de suivi , Hépatite auto-immune/traitement médicamenteux , Humains , Immunosuppresseurs/usage thérapeutique , Inde/épidémiologie , Foie/immunologie , Cirrhose biliaire/traitement médicamenteux , Mâle , Adulte d'âge moyen , Études prospectives , Études rétrospectivesRésumé
We describe a 65-year-old man who had had a permanent cardiac pacemaker implanted in 1994 and presented now with ascites. He was investigated for 3 months without finding any cause. He was admitted with a colonic bleed due to a polyp; on cardiac evaluation he was found to have pacemaker syndrome. After adjusting the pacemaker settings his ascites and pleural effusion (which had developed later) disappeared.