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Model for end-stage liver disease-Na score or Maddrey discrimination function index, which score is best?

World Journal of Hepatology 2015年第17期7卷 2119-2126页

作者： Mercedes Amieva-Balmori scherezada maría isabel mejia-loza Roberto Ramos-González Felipe Zamarripa-Dorsey Eli García-Ruiz Nuria Pérez y López Eumir I Juárez-Valdés Adriana López-Luria José maría Remes-Troche Servicio de Gastroenterología Instituto de Investigaciones Médico-Biológicas de la Universidad VeracruzanaHospital Juárez de México Laboratorio de Fisiología Digestiva Instituto de Investigaciones Médico-Biológicas de la Universidad Veracruzana

AIM: To compare the ability of model for end-stage liver disease(MELD)-Na and Maddrey discrimination function index(DFI) to predict mortality at 30 and 90 d in patients with alcoholic hepatitis(AH).METHODS: We prospectively assessed 52 patients with AH. Demographic, clinical and laboratory parameters were obtained. MELD-Na and Maddrey DFI were calculated on admission. Short-term mortality was assessed at 30 and 90 d. Receiver operating characteristic curve analysis was performed. RESULTS: Thirty-day and 90-d mortality was 44% and 58%, respectively. In the univariate analysis, sodium levels was associated with mortality at 30 and 90 d(P = 0.001 and P = 0.03). Child stage, encephalopathy, ascites, or types of treatment were not associated with mortality. MELD-Na was the only predictive factor for mortality at 90 d. For 30-d mortality area under the curve(AUC) was 0.763(95%CI: 0.63-0.89) for Maddrey DFI and 0.784 for MELD-Na(95%CI: 0.65-0.91, P = 0.82). For 90-d mortality AUC was 0.685(95%CI: 0.54-0.83) for Maddrey DFI and 0.8710 for MELD-Na(95%CI: 0.76-0.97, P = 0.041). CONCLUSION: AH is associated with high shortterm mortality. Our results show that MELD-Na is a more valuable model than DFI to predict short-term mortality.

关键词： Alcoholic hepatitis Model for end-stageliver disease-Na Maddrey Mortality

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Autoimmune Hepatitis as a Hepatic Manifestation of Common Variable Immunodeficiency: A Case Report

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Open Journal of Gastroenterology 2022年第8期12卷 186-191页

作者： Oscar Leonel García Rodas Francisco Sánchez Salinas scherezada maria isabel mejia loza Department of Gastroenterology Hospital Juárez of México México City México

Common variable immunodeficiency (CVID) is one of the most prevalent primary immunodeficiency disorders, characterized by an alteration in the maturation of B lymphocytes. Patients with this condition are redisposed to a higher risk of infections. Despite being an immune deficiency disorder, the prevalence of autoimmune disorders is reported in more than 20% of patients. The likelihood of patients’ gastrointestinal tract being affected is relatively low, close to 6%. We present the case of a 22-year-old man with a history of CVID without medical treatment, who presented with upper gastrointestinal bleeding secondary to esophageal varices due to cirrhotic portal hypertension. Infectious and toxic causes of cirrhosis were ruled out. Histological changes compatible with autoimmune hepatitis (AIH) were documented by liver biopsy. The diagnosis of autoimmune diseases is a challenge in the presence of IDCV, we highlight the importance of establishing a timely diagnosis and an intentional search for these conditions to offer timely treatment and avoid late complications.

关键词： Immunodeficiency Hepatitis Liver Autoimmune

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