1. A paradigm shift in non-viral liver cirrhosis: a multicenter study on clinicoepidemiological characteristics and outcome of non-B non-C cirrhosis.
- Author
-
Ramadan, Haidi Karam-Allah, El-Raey, Fathiya, Zaky, Samy, Bakr, Asmaa, Meghezel, El-Zahraa M., Bazeed, Shamardan Ezzeldin S., Badawi, Rehab, Abd-Elsalam, Sherief, Elbadry, Mohamed, Hagag, Mahmoud, and Abu Rahma, Mohamed Zakaria
- Subjects
CIRRHOSIS of the liver ,BUDD-Chiari syndrome ,RURAL children ,HEPATOLENTICULAR degeneration ,CLINICAL epidemiology ,CHOLANGITIS ,BILIARY liver cirrhosis - Abstract
Background: Chronic hepatitis C (HCV) and B viruses (HBV) represent the commonest global causes of liver cirrhosis. Other etiologies of non-viral cirrhosis such as autoimmune, metabolic, vascular, or biliary diseases are underestimated. The study aimed to identify causes, clinicoepidemiological characteristics, and outcome of non-B non-C liver cirrhosis. This Egyptian multicenter study recruited patients with liver cirrhosis excluding HCV and HBV. Clinical evaluation and the mortality were recorded. Laboratory, radiological, and histopathological assessment to diagnose the etiology was performed. Results: One hundred eighty-eight patients were included: 54.3% were males. Autoimmune hepatitis (AIH) was the most common cause of cirrhosis (28.2%), followed by Budd-Chiari syndrome (BCS) in 25%, and cryptogenic in 23.9%. Metabolic causes such as Wilson's disease, non-alcoholic steatohepatitis (NASH), and hemochromatosis were reported in 7.4%, 3.2%, and 1.1%, respectively. Biliary and cardiac cirrhosis were less frequent. Older age was prevalent in hemochromatosis (67.5 ± 17.7 years) and NASH (60.7 ± 11), while young age in Wilson's disease (29.5 ± 14.8) and secondary biliary cirrhosis (14.8 ± 4.8). Rural residence was common (60.6%). Mortality was reported in BCS (40.4%), cryptogenic (28.9%), cardiac (25%), Wilson's disease (21.4%), AIH (17%), and NASH (16.7%). Hepatocellular carcinoma complicated 10.6% of cases. A significantly high percentage of patients had decompensated cirrhosis. Child–Pugh class and rural residence were significant predictors of mortality. Conclusion: This first report on non-B non-C cirrhosis in Egypt revealed a high prevalence of AIH, BCS, and cryptogenic cirrhosis. Advanced Child class and rural residence were the predictors of mortality. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF