Honeybees balance essential fatty acids and suffer cognitively from deficiency

Abstract Background and aims. Epidemiological data on autoimmune hepatitis (AIH) are scarce. In this study, we determined the clinical and epidemiological characteristics of AIH patients in the Netherlands (16.7 million inhabitants). Methods. Clinical characteristics were collected from 1313 AIH patients (78% females) from 31 centers, including all eight academic centers in the Netherlands. Additional data on ethnicity, family history and symptoms were obtained by the use of a questionnaire. Results. The prevalence of AIH was 18.3 (95% confidential interval [CI]: 17.3-19.4) per 100,000 with an annual incidence of 1.1 (95% CI: 0.5-2) in adults. An incidence peak was found in middle-aged women. At diagnosis, 56% of patients had fibrosis and 12% cirrhosis in liver biopsy. Overall, 1% of patients developed HCC and 3% of patients underwent liver transplantation. Overlap with primary biliary cirrhosis and primary sclerosing cholangitis was found in 9% and 6%, respectively. The clinical course did not differ between Caucasian and non-Caucasian patients. Other autoimmune diseases were found in 26% of patients. Half of the patients reported persistent AIH-related symptoms despite treatment with a median treatment period of 8 years (range 1-44 years). Familial occurrence was reported in three cases. Conclusion. This is the largest epidemiological study of AIH in a geographically defined region and demonstrates that the prevalence of AIH in the Netherlands is uncommon. Although familial occurrence of AIH is extremely rare, our twin data may point towards a genetic predisposition. The high percentage of patients with cirrhosis or fibrosis at diagnosis urges the need of more awareness for AIH

Increased Mortality Among Patients With vs Without Cirrhosis and Autoimmune Hepatitis

Cellular mechanisms in basic and clinical gastroenterology and hepatolog

Drie patienten met een nierinfarct

Two patients, one 76-year-old-man and one 79-year-old-woman with cardiovascular disease and one 36-year-old-man with Factor-V-Leiden deficiency (activated protein C-resistance) had abdominal pain and elevation of LDH levels. With abdominal CT scan kidney infarction was diagnosed. In two cases a selective kidney arteriography was performed to confirm the diagnosis. Treatment consisted of (re)starting anticoagulant therapy. In unexplained abdominal pain with insufficiently specific results of physical examination combined with a rapid rise of the LDH and sometimes of the serum creatinine, a kidney infarction should be considered in the differential diagnosis