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Autoimmune hepatitis in humans

  • Stefan Lüth
  • Ansgar W. Lohse
Part of the Birkhäuser Advances in Infectious Diseases book series (BAID)

Abstract

Autoimmune hepatitis (AIH) can occur in all age groups from earliest childhood up until the 8th decade. AIH affects women more commonly than men (3:1). Clinical presentation may be an acute hepatitis up to fulminant liver failure, but can also be asymptomatic.

AIH is characterised by lympho-plasmacellular infiltrates on liver biopsy, elevated liver enzymes in serum and association with the HLA haplotypes B8, DR3 and DR4 in the absence of active viral markers. Patients characteristically present with hypergammaglobulinemia, elevated serum levels of IgG and autoantibodies, such as antinuclear antibodies (ANA), smooth muscle antibodies (SMA), antibodies to soluble liver antigen/ liver pancreas (SLA/LP) or to liver-kidney microsomes (LKM).

Corticosteroids are the drug of choice for remission induction, azathioprine the drug of choice for maintenance of remission. The rapid response to immunosuppressive treatment supports the diagnosis of AIH and leads to a good long-term prognosis. Treatment duration remains controversial and can be discussed after resolution of all clinical, laboratory and histological manifestations of disease activity. Treatment should be maintained for a minimum of 3 years.

Keywords

Primary Biliary Cirrhosis Primary SCLEROSING Cholangitis Autoimmune Hepatitis MYCOPHENOLATE MOFETIL Fulminant Liver Failure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Birkhäuser Verlag Basel/Switzerland 2008

Authors and Affiliations

  • Stefan Lüth
    • 1
  • Ansgar W. Lohse
    • 1
  1. 1.Department of MedicineUniversity Medical Center Hamburg-EppendorfHamburgGermany

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