Abstracts of the 2023 Annual Meeting of the ALEH
More infoAutoimmune liver diseases (ALD) are entities with well-defined clinical, diagnostic and therapeutic characteristics, which share autoimmune phenomena in their pathogenesis. In their clinical evolution, when they are not controlled, they progress to cirrhosis and its complications. We aimed to describe the clinical evolution and long-term survival of patients with ALD.
Materials and MethodsA retrospective cohort study was carried out in 77 patients diagnosed with ALD, seen in the hepatology clinic of the Centro de Investigaciones Médico Quirúrgicas, between 2000 and 2022, with a mean follow-up of 9 years (minimum 2 and maximum of 19). The main variables were: initial stage, form of presentation, complications and clinical evolution. The data was processed with the statistical package SPSS version 19.0 on Windows, the analysis was carried out by calculating the mean, standard deviation and percentage, and for survival, the Kaplan-Meier method was used with a confidence interval of 95%.
ResultsOf 77 patients studied, the most frequent entity was autoimmune hepatitis (AIH) (61.3%), followed by primary biliary cholangitis (PBC) (24.7%). More than half of the patients with AIH and PBC had cirrhosis at the onset of the disease, of which 14.3% had decompensated cirrhosis. In the follow-up, the majority had liver complications; ascites was the most frequent in 53.2% and the insertion of cholangiocarcinoma stood out in 45.5% of the patients with Primary sclerosing cholangitis (PSC). The progression of the disease and the need for transplantation predominated in cholestatic diseases: PBC (89.5%/57.9%) and PSC (81.8%/36.4%), while AIH was the disease with the highest survival (59%) at 10 years.
ConclusionsThe clinical evolution of the patients with ALD was determined by the presence of the advanced stage at the time of diagnosis, which conditioned a low survival in the long-term follow-up.