Prevalence and clinical characteristics of alpha-1 antitrypsin deficiency in liver explants in a Mexican cohort
| Autor: | Alan G. Contreras, Jacqueline Cordova-Gallardo, Ernesto Márquez-Guillén, Armando Gamboa-Domínguez, Ignacio García-Juárez, Mario Vilatobá, Alejandro Campos-Murguía, Braulio A Marfil-Garza, Rodrigo Cruz-Martínez, Jazmín Arteaga-Vázquez, Braulio Martínez-Benítez, Nayelli C Flores-García, Pedro Valdez-Hernández |
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| Rok vydání: | 2021 |
| Předmět: |
Liver Cirrhosis
medicine.medical_specialty Alcoholic liver disease Cirrhosis medicine.medical_treatment Population Liver transplantation Gastroenterology 03 medical and health sciences Liver disease 0302 clinical medicine Liver Cirrhosis Alcoholic Non-alcoholic Fatty Liver Disease alpha 1-Antitrypsin Deficiency Internal medicine Prevalence medicine Humans education Liver injury education.field_of_study Alpha 1-antitrypsin deficiency Hepatology business.industry medicine.disease Diabetes Mellitus Type 2 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Steatohepatitis business |
| Zdroj: | Clinics and Research in Hepatology and Gastroenterology. 45:101519 |
| ISSN: | 2210-7401 |
| DOI: | 10.1016/j.clinre.2020.07.024 |
| Popis: | Introduction Alpha-1 antitrypsin deficiency (AATD) is a risk factor for liver disease. PASD-positive inclusions have been found unexpectedly in approximately 10% of liver explants in patients with no previous diagnosis of AATD, particularly, in patients with non-alcoholic steatohepatitis (NASH), supporting a synergistic mechanism of liver injury between AATD and environmental factors. We aimed to determine the clinical characteristics of mestizo patients in which AATD was diagnosed before or after liver transplantation. Methods Liver explants of patients with cryptogenic, alcoholic, and NAFLD/NASH cirrhosis undergoing orthotopic liver transplantation (OLT) were included. Liver histopathology was assessed by two expert pathologists. Hematoxylin and eosin staining, PASD staining, and confirmatory AAT immunohistochemistry were performed. In explants with positive histopathology, genotyping for SERPINA1 was performed. Results A total of 180 liver transplants were performed during the study period. Of these, 44 patients with cryptogenic cirrhosis, NASH, and alcoholic cirrhosis were included. Of these patients, two liver explants (4.5%) had PASD-positive inclusions stain and confirmatory immunochemistry. During the period evaluated, another two patients with a diagnosis of AATD before the OLT were also included. The four patients had overweight or obesity, three had type 2 diabetes mellitus, and two developed liver steatosis after the OLT. Conclusion AATD was found to be an infrequent finding in patients with cryptogenic, NASH/NAFLD, and alcoholic cirrhosis in our population. However, it is important to consider this entity as it may represent an additional factor in the appearance and progression of liver fibrosis in patients with metabolic syndrome. |
| Databáze: | OpenAIRE |
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