Clinical features of elderly Chinese patients with autoimmune hepatitis.

BACKGROUND/AIMS: To study the clinical features of elderly Chinese patients with autoimmune hepatitis. MATERIALS AND METHODS: The clinical features of 36 patients diagnosed at age >60 years were compared with those of 39 patients aged <50 years. RESULTS: The M:F ratio was 1:35 (>60 years) vs. 3:36 (<50 years). The patients >60 years had a higher frequency of cirrhosis at presentation than the patients <50 years (52.8% vs. 15.4%, p=0.001). The patients >60 years also had a significantly increased incidence of ascites at presentation (41.7% vs. 10.3%, p=0.001) and lower serum albumin levels (p=0.037). There were significant differences between older and younger patients with respect to the frequencies or titers of anti-nuclear antibody (46.2% vs. 83.3%, p=0.011). HLA DR3 positivity occurred more frequently in the patients <50 years than in those >60 years (59.0% vs. 19.4%, p<0.001), whereas HLA DR4 occurred more often in the patients >60 years (63.9% vs. 25.6%, p=0.001). Treatment failure occurred more frequently in the patients <50 years (28.2% vs. 9.1%, p=0.041). However, there were no significant differences between the groups with respect tomode of onset, other clinical signs at presentation biochemical parameters, and smooth muscle antibody positivity. CONCLUSION: Elderly patients have a greater frequency of cirrhosis at presentation, anti-nuclear antibody, HLA DR4 positivity than patients <50 years, and they have a lower occurrence of treatment failure. Conventional corticosteroid regimens may be an effective management for older patients with autoimmune hepatitis.

[Adriamycin or adriamycin-Fe3+ induced bovine serum albumin damage].

ESR spectroscopy was used to investigate the production of reactive oxygen radicals in adriamycin (ADM) and its iron complex. The results showed that ADM-Fe(3+) induced the production of oxygen radicals more efficiently than ADM. The damage of BSA mediated by ADM or ADM-Fe(3+) was investigated by measuring the increase of reactive carbonyl content and the decrease of the fluorescence intensity of the Trp residue. It was shown that the damage of bovine serum albumin (BSA) was dependent on the time and on the concentration of ADM or ADM-Fe(3+). Sodium dodecyl sulfate-polyacrylamide gel electrophoresis indicated that BSA was not cross-linked nor fragmented by the effect of ADM or ADM-Fe(3+). It was also found that oxygen radical scavengers could inhibit the damage of BSA induced by ADM or ADM-Fe(3+), suggesting that ADM or ADM-Fe(3+) induced protein damage via the oxygen radicals produced in the reaction.