Clinical narrative: autoimmune hepatitis

Am J Gastroenterol. 2018 Jul;113(7):951-958. doi: 10.1038/s41395-018-0058-z. Epub 2018 May 14.

Abstract

Autoimmune hepatitis (AIH) is an inflammatory liver disease that is characterized by circulating autoantibodies, hypergammaglobulinemia, and a lymphoplasmocytic infiltration with interface hepatitis on liver biopsy. Treatment with corticosteroids and other immunosuppressive agents is effective and early diagnosis can result in near-normal life expectancy. Untreated patients, however, can progress to cirrhosis and liver failure. The clinical presentation is heterogeneous and may pose diagnostic and therapeutic dilemmas. This case-based review will address the diagnosis and management of this disease, in addition to difficult but commonly encountered clinical scenarios.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Autoantibodies / blood
  • Azathioprine / administration & dosage
  • Azathioprine / therapeutic use
  • Biopsy
  • Cyclosporine / administration & dosage
  • Cyclosporine / therapeutic use
  • Decision Trees
  • Diagnosis, Differential
  • Female
  • Hepatitis, Autoimmune / blood
  • Hepatitis, Autoimmune / diagnosis*
  • Hepatitis, Autoimmune / drug therapy
  • Hepatitis, Autoimmune / pathology
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / therapeutic use
  • Liver / pathology

Substances

  • Autoantibodies
  • Immunosuppressive Agents
  • Cyclosporine
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Azathioprine