Diagnosis and treatment of autoimmune hepatitis

Curr Gastroenterol Rep. 2012 Feb;14(1):25-36. doi: 10.1007/s11894-011-0236-2.

Abstract

Autoimmune hepatitis is a chronic liver disease characterized by elevated aminotransferase levels, autoantibodies, increased γ-globulin or IgG levels and biopsy evidence of interface hepatitis. Recent advances include new practice guidelines that redefine criteria for remission to require complete biochemical and histological normalization on therapy; comparisons between the revised original and simplified diagnostic scoring systems; refined characterization of autoantibodies and their diagnostic performance parameters; proof of the safety and efficacy of combination budesonide and azathioprine therapy for non-cirrhotic patients; scrutiny of overlap syndromes; further analyses of the outcomes of orthotopic liver transplantation and the diagnosis and treatment of recurrent and de novo autoimmune hepatitis after transplantation. Anticipated consequences of the application of the new definition of therapeutic remission include a reduction in the proportion of patients achieving remission with conventional immunosuppression regimens and a corresponding increase in the need for alternative therapies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Autoantibodies / blood
  • Hepatitis, Autoimmune* / diagnosis
  • Hepatitis, Autoimmune* / therapy
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Liver Transplantation

Substances

  • Autoantibodies
  • Immunosuppressive Agents