Autoimmune chronic active hepatitis in a family

Article Abstract:

In autoimmune diseases, the body's immune system mistakenly identifies a tissue type or secretory product as being a foreign substance, and produces antibodies against those parts of itself that it identifies as such. Insulin-dependent diabetes mellitus and celiac disease are two well studied forms of autoimmune disease; recent evidence suggests that at least one variant of chronic active hepatitis (an inflammatory condition affecting the liver) may have an autoimmune component. Close relatives of patients with chronic active hepatitis are reported to have a higher incidence of autoimmune disorders, suggesting a strong genetic basis; no compelling evidence has been reported to date documenting increased intrafamily incidence of this condition. A family is described in which five of seven siblings developed autoimmune conditions including multiple instances of chronic active hepatitis. Three sisters developed chronic active hepatitis, one sister yielded blood test results that indicated a degree of autoimmunity (asymptomatic at that point), and another sister developed celiac and thyroid autoimmune conditions. Two brothers were healthy and had no signs of autoimmunity of any sort. Biochemical analysis of the immune system background (determination of HLA type) of each sibling in the family indicated that, in association with the female sex, the DR3 histocompatibility antigen seemed to be more important than the B8 antigen in conferring susceptibility to autoimmune hepatitis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Genetic aspects, Autoimmune diseases, Genetic disorders, Chronic active hepatitis

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Survival and place of treatment after premature delivery

Article Abstract:

Although the intensive care of newborns (neonates) is both costly and complicated, it has reduced the death rate among premature infants within the last 20 years. However, the benefits of rapid growth in the area of neonatal intensive care are questionable, because the effectiveness of this specialized care has not been assessed. In addition, the overall effectiveness of specific newborn therapies, such as artificial ventilation for respiratory distress syndrome, has not been evaluated. The relation between different methods of neonatal care and survival after premature delivery was assessed in the Trent region of the United Kingdom over a one year period. A total of 1,443 infants requiring admission to a neonatal care unit were evaluated. Among the infants born at 28 weeks' gestation or less, survival rates were better for those treated at large centers than for those treated at small centers. Thirty-four of 65 infants treated at one of five large centers survived, compared with the survival of eight of 37 infants treated at 12 smaller units. These findings suggest that neonatal services may be more effective if they are centralized into large units, particularly for infants of 28 weeks' gestation or less. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Evaluation, Patient outcomes, Mortality, Infants (Premature), Premature infants, Neonatal intensive care, Infant mortality

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