Autoimmune hepatitis Flashcards
(5 cards)
What is autoimmune hepatitis?
Autoimmune hepatitis is a rare cause of chronic liver inflammation, caused by a combination of genetic and environmental factors. It involves the immune system attacking the liver cells, leading to liver damage.
What are the two types of autoimmune hepatitis and how do they differ?
Type 1:
* Affects women in their late 40s or 50s, often after menopause.
* Presents with fatigue and features of liver disease.
* Takes a less acute course than type 2.
Type 2:
* More common in children or young people, especially girls.
* Presents with acute hepatitis, high transaminases, and jaundice.
What investigations are used to diagnose autoimmune hepatitis?
Liver function tests: High transaminases (ALT and AST), with minimal increase in ALP.
Raised IgG levels.
Autoantibodies:
* Type 1: Anti-nuclear antibodies (ANA), anti-smooth muscle antibodies (anti-actin), anti-soluble liver antigen (anti-SLA/LP).
* Type 2: Anti-liver kidney microsomes-1 (anti-LKM1), anti-liver cytosol antigen type 1 (anti-LC1).
Liver biopsy: Shows interface hepatitis and plasma cell infiltration.
What are the key histological features seen in autoimmune hepatitis on liver biopsy?
Interface hepatitis: Inflammation at the junction between the liver cells and the portal area.
Plasma cell infiltration: Presence of plasma cells within the liver tissue.
How is autoimmune hepatitis managed?
First-line treatment: High-dose steroids (e.g., prednisolone).
Other immunosuppressants: Azathioprine is commonly used.
Goal: To induce remission and control the disease.
Liver transplant: May be required in end-stage liver disease, though autoimmune hepatitis can recur in the transplanted liver.
