ABSTRACT
INTRODUCTION: For the diagnosis of liver diseases, clinical criteria, biochemical, immunological and histological parameters are included. The autoimmune panel is an immunoblot that contemplates the detection of antibodies against 9 different hepatic antigens, which could guide the diagnosis of these pathologies. OBJECTIVE: To describe the usefulness of the autoimmune panel in the diagnosis of liver diseases. Methods: Observational, descriptive study. All autoimmune panels performed between January 2020 and August 2021 (n = 279) were reviewed, and the ones with positive result selected (n = 101). Clinical records were reviewed, including: clinical, biochemical, immunological and histological characteristics. Diagnosis was determined by clinical suspicion (clinical, biochemical and immunological parameters), only through autoimmune panel, and according to liver biopsy in available cases. RESULTS: 45 patients with complete clinical history were included in the analysis; 82% women, median age 58 years (16-79). Clinical suspicions included autoimmune hepatitis (AIH) in 12 patients (27%), primary biliary cholangitis (PBC) in 10 patients (22%), overlap syndrome (AIH/PBC) in 17 (38%), and others in 6 (13%). The diagnosis of PBC was confirmed by autoimmune panel in 9/10 and 11/17 patients with clinical suspicion of PBC and HAI/PBC, respectively. Of the 27 patients with initial clinical suspicion of PBC, 14 had negative AMA and AMA-M2 (6 had Sp100 and 5 gp210 as the only markers and 3 had positive Sp100 and PML). In 10/14 patients, the diagnosis was confirmed by panel and/or compatible liver biopsy. CONCLUSION: The autoimmune panel turns out to be a useful diagnostic tool for liver diseases, especially PBC in isolation or in overlap syndrome.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Autoantibodies/blood , Immunoblotting/methods , Hepatitis, Autoimmune/diagnosis , Hepatitis, Autoimmune/immunology , Hepatitis, Autoimmune/blood , Liver Diseases/diagnosis , Liver Diseases/immunology , Autoimmune Diseases/diagnosis , Autoimmune Diseases/immunology , Autoimmune Diseases/blood , Liver Cirrhosis, Biliary/diagnosis , Liver Cirrhosis, Biliary/immunology , Liver Cirrhosis, Biliary/bloodABSTRACT
INTRODUCTION: For the diagnosis of liver diseases, clinical criteria, biochemical, immunological and histological parameters are included. The autoimmune panel is an immunoblot that contemplates the detection of antibodies against 9 different hepatic antigens, which could guide the diagnosis of these pathologies. OBJECTIVE: To describe the usefulness of the autoimmune panel in the diagnosis of liver diseases. METHODS: Observational, descriptive study. All autoimmune panels performed between January 2020 and August 2021 (n = 279) were reviewed, and the ones with positive result selected (n = 101). Clinical records were reviewed, including: clinical, biochemical, immunological and histological characteristics. Diagnosis was determined by clinical suspicion (clinical, biochemical and immunological parameters), only through autoimmune panel, and according to liver biopsy in available cases. RESULTS: 45 patients with complete clinical history were included in the analysis; 82% women, median age 58 years (16-79). Clinical suspicions included autoimmune hepatitis (AIH) in 12 patients (27%), primary biliary cholangitis (PBC) in 10 patients (22%), overlap syndrome (AIH/PBC) in 17 (38%), and others in 6 (13%). The diagnosis of PBC was confirmed by autoimmune panel in 9/10 and 11/17 patients with clinical suspicion of PBC and HAI/PBC, respectively. Of the 27 patients with initial clinical suspicion of PBC, 14 had negative AMA and AMA-M2 (6 had Sp100 and 5 gp210 as the only markers and 3 had positive Sp100 and PML). In 10/14 patients, the diagnosis was confirmed by panel and/or compatible liver biopsy. CONCLUSION: The autoimmune panel turns out to be a useful diagnostic tool for liver diseases, especially PBC in isolation or in overlap syndrome.
Subject(s)
Autoantibodies , Hepatitis, Autoimmune , Immunoblotting , Liver Diseases , Humans , Female , Autoantibodies/blood , Male , Middle Aged , Adult , Aged , Adolescent , Young Adult , Immunoblotting/methods , Hepatitis, Autoimmune/immunology , Hepatitis, Autoimmune/diagnosis , Hepatitis, Autoimmune/blood , Liver Diseases/immunology , Liver Diseases/diagnosis , Liver Cirrhosis, Biliary/immunology , Liver Cirrhosis, Biliary/diagnosis , Liver Cirrhosis, Biliary/blood , Autoimmune Diseases/immunology , Autoimmune Diseases/diagnosis , Autoimmune Diseases/bloodABSTRACT
El síntoma dolor torácico es uno de los motivos de consulta que más preocupa a los padres por la posibilidad de que el trasfondo sea de estructuras tan nobles como el corazón. La anammesis y el exámen físico logran en la mayoría de los casos dilucidar la etiología.