Autoimmune Hepatitis

Question 1

What is autoimmune hepatitis?

Answer 1

It is defined as a condition in which liver inflammation is related to the targeting of the body’s own immune system

Question 2

What are the two classifications of autoimmune hepatitis?

Answer 2

Type One Autoimmune Hepatitis

Type Two Autoimmune Hepatitis

Question 3

What is type one autoimmune hepatitis?

Answer 3

It is defined as the formation of the following antibodies against the liver…

• Anti-nuclear antibodies (ANA)
• Anti-smooth muscle antibodies (anti-SMA)
• Anti-soluble liver antigen antibodies (anti-SLA/LP)

Question 4

Which patient group tend to be affected by type one autoimmune hepatitis?

Answer 4

Women

40 - 50 Years Old

Menopause Stage

Question 5

What is type two autoimmune hepatitis?

Answer 5

It is defined as the formation of the following antibodies against the liver…

• Anti-liver kidney microsomes-1 antibodies (anti-LKM1)
• Anti-liver cytosol antigen type one antibodies (anti-LC1)

Question 6

Which patient group tend to be affected by type two autoimmune hepatitis?

Answer 6

Young Adults

Question 7

What are the four risk factors of autoimmune hepatitis?

Answer 7

Female Gender

Family History

Autoimmune Diseases

Viral Infections

Question 8

Which six viral infections are associated with autoimmune hepatitis?

Answer 8

Measles

Herpes simplex

Epstein Barr

Hepatitis A

Hepatitis B

Hepatitis C

Question 9

What are the seven clinical features of autoimmune hepatitis?

Answer 9

Abdominal Pain

Jaundice

Amenorrhoea

Arthralgia

Urticarial Rash

Hepatomegaly

Spider Angiomas

Question 10

What two investigations are used to diagnose autoimmune hepatitis?

Answer 10

Blood Tests

Liver Biopsy

Question 11

What five blood test results indicate autoimmune hepatitis?

Answer 11

Increased ALT Levels

Increased AST Levels

Increased IgG Levels

Increased Bilirubin Levels

Autoantibody Detection

Question 12

What is the gold standard investigation used to diagnose autoimmune hepatitis?

Answer 12

Liver biopsy

Question 13

What are the four features of autoimmune hepatitis on liver biopsy?

Answer 13

Portal Inflammation

Interface Hepatitis

Lymphoplasmacytic Infiltrate

Acinar Transformation of Hepatocytes

Question 14

What are the two pharmacological management options for autoimmune hepatitis?

Answer 14

Corticosteroids

Immunosuppressants

Question 15

Name a corticosteroid used to manage autoimmune hepatitis

Answer 15

Prednisolone

Question 16

What is the first line management option used to manage autoimmune hepatitis?

Answer 16

Corticosteroids

Question 17

How are corticosteroids administer to manage autoimmune hepatitis?

Answer 17

These are the initial drugs administered

They are then tapered over time as other immunosuppressants are introduced

Question 18

Name an immunosuppressant used to manage autoimmune hepatitis

Answer 18

Azathioprine

Question 19

What is the second line management option used to manage autoimmune hepatitis?

Answer 19

Immunosuppressants

Question 20

How are immunosuppressants administered to manage autoimmune hepatitis?

Answer 20

They are administered chronically to induce remission of disease

Question 21

What is the surgical management option for autoimmune hepatitis?

Answer 21

Liver transplant

Question 22

When are liver transplants considered in autoimmune hepatitis?

Answer 22

End stage liver disease

Question 23

What is important to note about the use of liver transplant to manage autoimmune hepatitis?

Answer 23

It can reoccur in transplanted livers

Question 24

What are the three complications of autoimmune hepatitis?

Answer 24

Liver Cirrhosis

Liver Failure

Hepatocellular Carcinoma