Auto immune hepatitis (not needed)

Question 1

what 3 differentials can you form from:

jaundice, upper abdo pain, palpable liver & spleen, spider naevi, high Fe, no excess alcohol. Young woman.

Answer 1

viral hepatitis
autoimmune hepatitis
non-alcoholic fatty liver disease

Question 2

ANA & SMA are elevated in suspected AIH. What investigation is needed to make a diagnosis? why?

Answer 2

liver biopsy

check for ^necrosis, fibrosis, cirrhosis, plasma cells?

Question 3

What medication is given for AIH?

Answer 3

either:
high dose steroid eg prednisolone 30mg
high dose steroid + azathioprine 50mg (test TMPT levels first)

Question 4

AIH treatment how long?

Answer 4

• at least 2 years
• liver biopsy before stopping therapy
• sometimes lifelong

Question 5

What to do if taking azathioprine & pregnant?

Answer 5

continue use