- Clinical science
Autoimmune hepatitis (AIH) is a rare form of chronic hepatitis that predominantly affects women. Although the etiology is unclear, it is commonly associated with other autoimmune conditions (e.g., type 1 diabetes mellitus, celiac disease). Clinical presentation varies and patients may be asymptomatic or even show signs of acute liver failure. Diagnosis is established based on the detection of autoantibodies (especially anti-smooth muscle antibodies) and the histologic findings of liver biopsy. Treatment consists of immunosuppressive medications such as prednisone and azathioprine. The prognosis is favorable if patients are treated appropriately; without treatment, cirrhosis may develop.
AIH has an insidious onset in most patients and its presentation varies widely, ranging from asymptomatic disease to severe symptoms or even acute liver failure.
- Abdominal pain
- Weight loss
- Signs of acute liver failure (∼ ⅓ of patients)
- ↑ ALT and ↑ AST
- Normochromic anemia, thrombocytopenia, mild leukopenia, ↑ erythrocyte sedimentation rate (ESR)
- Autoantibodies: Type 1 AIH: antinuclear antibodies (ANA); and (ASMA)
- Hypergammaglobulinemia (↑ IgG)
- Liver biopsy: Biopsy should be performed following the detection of AIH antibodies to confirm the diagnosis.
Diagnosis is established based on positive autoantibodies (e.g., anti-smooth muscle antibodies) and histological findings suggestive of autoimmune hepatitis!
- Viral hepatitis (e.g., )
The differential diagnoses listed here are not exhaustive.