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- Title
Diagnosis and treatment of autoimmune hepatitis at age 65 and older.
- Authors
Verslype, C.; George, C.; Buchel, E.; Nevens, F.; Van Steenbergen, W.; Fevery, J.
- Abstract
To study features in older patients with autoimmune hepatitis, as this was considered mainly a disease of young females.Analysis of 28 patients diagnosed at age≥65 years compared with 84 younger patients.The incidence was similar at all age decades. The ratio M:F was 1 : 3 (≥65 years) vs. 1 : 2 (<65 years). Presenting symptoms were not different when compared with younger patients and consisted of general malaise and fatigue (36%), jaundice ± other symptoms (50%), or ascites (11%).Antinuclear antibodies (ANA) ≥ 1/80 were positive in 93%, smooth muscle antibodies (SMA) > 1/40 in 50%, anti-liver kidney microsomes (anti-LKM) proved always negative. Histology showed acute necrotizing hepatitis in 19%, severe interphase hepatitis in 15%, chronic hepatitis with plasmo-lymphocytic infiltrate in 30%, cirrhosis in 29% (with active inflammation in one-third); biopsy was refused in 11%. The elderly responded very well to low doses of methylprednisolone (≤8 mg) and azathioprine (1 mg/kg). This schedule obviates side-effects such as infections seen with higher dosages.Autoimmune hepatitis has to be also looked for in the elderly with acute and chronic hepatitis. The steroid therapy should be individualized but kept at a low dose.
- Subjects
CHRONIC active hepatitis; DISEASES in older people; DISEASES in women; FATIGUE (Physiology); JAUNDICE; IMMUNOGLOBULINS
- Publication
Alimentary Pharmacology & Therapeutics, 2005, Vol 21, Issue 6, p695
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/j.1365-2036.2005.02403.x