Hepatology: Hepatitis Flashcards
What is the typical patient with autoimmune hepatitis?
Young or middle-aged woman
What conditions is autoimmune hepatitis associated with?
Other autoimmune conditions
How does autoimmune hepatitis present?
1) Jaundice
2) Fatigue
3) Loss of appetite
4) Hepatomegaly
5) Splenomegaly
6) Abdominal pain
What do LFTs usually show in autoimmune hepatitis?
Hepatic pattern of disease
1) Raised ALT
2) Raised bilirubin
3) Normal/mildly raised ALP
What will antibody levels show in autoimmune hepatitis?
IgG predominant hypergammaglobulinaemia
Which type of antibody is predominant in autoimmune hepatitis?
IgG
Which antibodies are present in autoimmune hepatitis (type 1)?
Anti-smooth muscle antibodies (anti-SMA) ± ANA
What are the features of type II and type III autoimmune hepatitis?
1) Type II - less common, often more severe, positive for anti liver/kidney microsomal antibodies type 1
2) Type III - less common, often positive for anti-soluble liver antigen
Type II and III AIH are negative for anti-smooth muscle antibodies and antinuclear antibodies.
What is the most common type of autoimmune hepatitis?
Type I
How is autoimmune hepatitis diagnosed?
Blood results (antibodies) + liver biopsy
How is autoimmune hepatitis managed?
1) Prednisolone - to induce remission
2) Azathioprine - to maintain remission
3) For patients who do not respond to standard treatment, second-line treatment with other immunosuppressants can be effective
What medication is used to induce remission in autoimmune hepatitis?
Prednisolone
What medication is used to maintain remission in autoimmune hepatitis?
Azathioprine
Which hepatitis viruses are notifiable diseases in the UK?
All
Which hepatitis viruses cause chronic infection?
B + C + D
