Autoimmune Hepatitis

Question 1

Which age group is predominately affected by autoimmune hepatitis?

Answer 1

Young or middle-aged women

Question 2

What is this a presentation of (in 40% of cases)?
Acute hepatitis, signs of autoimmune disease (fever, malaise, urticarial rash, polyarthritis, glomerulonephritis). Gradual jaundice in remainder.

Answer 2

Autoimmune hepatitis

Question 3

How is suspected autoimmune hepatitis investigated?

Answer 3

1. Raised bilirubin, AST, ALT, ALP

2. Anti-smooth muscle Abs +ve in 80%

Question 4

What is the treatment for autoimmune hepatitis?

Answer 4

1. Prednisolone 30mg/d PO for 1 month
2. Reduce by 5mg a month to maintenance dose of 5-10mg for 2 years.
3. Relapses occur in 80%
4. Azathioprine as steroid sparing agent to maintain remission (achievable in 80%)