Kriterier for diagnose og behandling av autoimmune leversykdommer. Gjennomgang av pasientmateriale i tiden 2000-2006 ved Gastromedisinsk avdeling, Ullevål Universitetssykehus.

Abstract

Abstract

Objectives/background/method Autoimmune liver disorders include autoimmune hepatitis (AIH), primary biliary cirrosis (PBC) and primary sclerosing cholangitis (PSC). The purpose of this study was to assess the diagnostic criteria of these liver diseases in patients seen in the Department of Gastroenterology, Ullevål Hospital during a seven years period, 2000-2006. Clinical and biochemical data were retrospectively registered from the patient’s medical journal.

Results Strong correlation exists between recommended diagnostic criteria and those actually applied in all three groups of diseases. Treatment of AIH with prednisolone and or azathioprine has good effect on 56 % of the patients. Utilization of UCDA in the treatment of PBC was very effective, in lowering liver enzymes. With PSC patients, UCDA monotherapy was not adequate. Functional liver tests are also here used as efficiency measurement. Immunoglobulines was only used in the diagnostic process and not later in follow up. History of alcohol and drug abuse was poorly documented. Documentation was not available for 50 % of the AIH patients and in 67 % of the PBC patients.

Conclusion Diagnostic criteria are met in the diagnostic process of patients with autoimmune liver diseases. In the out-patient follow up the examinations and tests vary, and protocols stating guidelines would represent an improvement. History of alcohol and drug abuse was surprisingly poorly documented and the potential for improvement in this matter is overt.