Otoimmün Hepatit Hastalarında Serum Ada (Adenozin Deaminaz) Düzeyi ve Karaciğer Histolojisi ile Ilişkisinin Araştırılması

Abstract

In this study, it is aimed to compare the Auto Immune Hepatitis (AIH) patients' serum ADA level with histopathological features of liver biopsy. This study was made by determination of ADA levels in the serum samples which were taken at the time of diagnosis of AIH, at Hacettepe University Department of Gastroenterology. Patients' data was obtained from the local database (Nukleus). Patients were diagnosed according to Simplified International Autoimmune Hepatitis Group (IAIHG) criteria which is set by 2008. We studied serum ADA level in 52 consecutive patients with AIH and in 28 age and sex matched controls. Mean ADA levels were found 25,4 ± 9,6 U/L in AIH patients, 12,8 ± 2,2 U/L in controls; this difference was statistically significant (p <0.001). When the threshold value of ADA accepted as 20 U/L, ADA level in AIH patients was found significantly higher than the control group (% 64 v.s. % 0, p <0.001). AIH patients were with similar characteristics in terms of age and sex when analyzed according to inflammatory activity. The mean ADA level was 15,2 ± 3,5 U/L in patients with mild interface hepatitis, 23,1 ± 10,0 U/L in patients with moderate interface hepatitis and 30,9 ± 7,0 U/L in patients with severe interface hepatitis. Correlation analysis showed that serum ADA levels were associated significantly with inflammatory activity (r = 0,71, p < 0,001). For severe interface hepatitis, 24,55 U/L cut off value of ADA had % 88 sensitivity and % 85,2 specifity, reciever operating characteristic (ROC) curve showed an area under the curve (AUC) of 0,88. In conclusion, ADA levels are significantly higher in AIH patients. Furthermore, in these patients, there is a positive correlation between ADA levels and inflammatory activity.