AIH

Question 1

Classification of AIH

Answer 1

1-Type 1 Autoimmune Hepatitis (Classic Type)
*Most common form of AIH (about 80% of cases).
*Typically affects adolescents and adults, but can occur at any age.

*Associated autoantibodies:
ANA (antinuclear antibodies)
ASMA (anti-smooth muscle antibodies)
Sometimes anti-actin or anti-SLA/LP (soluble liver antigen/liver-pancreas)
*Often associated with other autoimmune diseases.

Question 2

Classification of AIH

Answer 2

2-Type 2 Autoimmune Hepatitis
*Less common, primarily affects children and young adults.
*More severe course and higher risk of progression to cirrhosis.
Associated autoantibodies:
*Anti-LKM-1 (liver kidney microsomal type 1 antibodies)
Sometimes anti-LKM-3 or anti-LC1 (liver cytosol type 1 antibodies.
*May overlap with features of viral hepatitis.

Question 3

Classification of AIH

Answer 3

3-Type 3 Autoimmune Hepatitis
*Some consider this a subset of Type 1 or a separate entity.
*Associated with anti-SLA/LP antibodies.
*Clinical features are similar to Type 1, but some patients may test negative for ANA or ASMA.

Question 4

State the diagnostic criteria for the autoimmune hepatitis (AIH),
primary biliary cholangitis (PBC) and overlap syndrome?

Answer 4

Defined by the Paris Criteria – diagnosis requires meeting ≥2 features of both AIH and PBC:

AIH Features (≥2 of the following):

ALT ≥5× ULN

IgG ≥2× ULN or positive SMA

Liver biopsy: moderate to severe interface hepatitis

PBC Features (≥2 of the following):

ALP ≥2× ULN or GGT ≥5× ULN

AMA positivity

Liver biopsy: florid duct lesion (typical of PBC)