Profil Epidemiologique, Clinique et Biologique des Ptients presentants des Hepatopathies Auto-Immunes

Abstract

Our study consisted in determining the epidemiological profile, as well as the clinical-biological characteristics of patients who are affected by autoimmune hepatopathy in the region of Sétif. Autoimmune liver disease (autoimmune hepatitis (HAI), primary biliary cholangitis (PBC) and overlapping syndrome (HAI-CBP)) are immune-mediated chronic inflammatory liver diseases, exposing the patient to the risk of developing cirrhosis or even liver failure. The precise etiology of these autoimmune liver diseases during the period of our research remained elusive. This is a retrospective descriptive study, which took place over a period of 06 months. Our sample concerned forty (40) patients with hypertension, whose ages vary between 08 and 77 years and which were collected at the CHU of Sétif. The results of our research showed that 40% of patients are affected by autoimmune hepatitis. The remaining cases are 32.5% for PBC and 27.5% for Overlap Syndrome. We noted a female predominance with a sex-ratio H/ F of 0.33, which means that one man for three (03) women are affected by these diseases. We detected in symptomatic people two most common symptoms namely asthenia and jaundice. The remaining cases were asymptomatic. Biologically, we found cholestasis-like hepatic disturbances, with polyclonal hypergammaglobulinemia mainly of the IgM type that were frequently associated with PBC. In addition, hepatic cytolysis and predominantly IgG hypergammaglobulinemia were noted in most cases that had HAI. Analysis of the autoantibody profile in patients with HAI revealed positive ANA results as well as anti-ML Ac. CBP was characterized, essentially, by the presence of MAAs in 70% of cases. Almost all cases diagnosed at an advanced stage of HAI with signs of severity had high rates of anti-ML Ac and this allowed us to detect a correlation between the anti-ML Ac title and the evolutionary stage of the disease. While, we found no particular connection between the AAM title and the CBP clinic.