Autoimmune Liver Disease Flashcards
What are the 3 main autoimmune liver disease
- Autoimmune hepatitis
- Primary sclerosing cholangitis
- Primary biliary cirrhosis
What is an autoimmune hepatitis
T cell mediated destruction of hepatocyte
B cell and plasma cell involved by hypergammaglobulinaemia (igm and igg)
Autoantibodies
What histological changes can we see in auto immune hepatitis
Portal inflammation with numerous plasma cells
Prominent interface hepatitis with balloonng/rosetting of periportal hepatocytes
Lobular inflammation with zone 3 necrosis
What is the presentation of autoimmune hepatitis
Jaundice
Chronic hepatitis
Cirhosis
What is the aim for treating autoimmune hepatitis
Prevent: Liver cirhosis Ascites Splenomegaly Variceal bleeding Encephalopathy
What is the treatment of autoimmune hepatitis
High dose steroids called azathioprine with and without low dose prednisolone
What happens when there is autoimmune hepatitis and it is not treated
- Chronic acitve hepatitis
- This can lead to compensated cirrhosis
- This can lead to decompensated cirrhosis and then to liver cancer
What is primary bilary cholangitis
Destruction of the intrahepatic small bile ducts by effector t cells i.e cd4 t cells
What can happen if primary biliary cholangitis progresses
It can lead to liver cirrhosis
Liver cirrhosis can develop to liver failue or liver cancer
What is the treatment of primary biliary cholangitis
Liver transplant if there is liver failure Ursodeoxycholic acid (not curative)
What are the symptoms of primary biliary cirrhosis
Itchiness
Constant fatigue
Depression
What can itching be treated with in primary biliary cirrhosis
Cholestryamine
Rifampicin
Sertraline
What is primary sclerosing cholangitis
Disease of the large extrahepatic bile duct
What is the diagnosis of primary sclerosing cholangitis made by
MRCP
What other condition can people with primary sclerosing cholangitis suffer with
IBD
