Autoimmune Hepatitis

Question 1

Autoimmune Hepatitis AKA …

Answer 1

Lupoid hepatitis
very rare
causes lupus like rash

Question 2

What is autoimmune hepatitis?

Answer 2

Adaptive immunity mounts autoimmune response vs hepatocytes

Question 3

RF of auto hepatitis?

Answer 3

Females
Other autoimmune disease eg. SLE
Viral hepatitis (increase risk of developing autoimmune hep)
HLA DR3 OR 4

Question 4

What is T1 and T2?
who does it occur in?
% of cases?
2 Ab for each?

Answer 4

T1-Adult female (80% cases)
ANA (anti nuclear Ab - found in many autoimmune diseases eg. SLE but very specific for T1 auto hepatitis)
ASMA (anti smooth muscle Ab)

T2 - Young females (rarer)
ALC-1 (anti liver cytoid)
ALKM-1 (Anti liver kidney microsome)

Question 5

Patient presentation?

Answer 5

25% aSx
Many = Jaundice, fever, hepatosplenomegaly

Question 6

Dx of auto hep?

Answer 6

Serology
ANA, ASMA +/- ALC-1, ALKM-1

Question 7

Tx of auto hep?

Answer 7

Corticosteroids (prednisolone) + azathioprine
+ Hep A + B vaccination
Last resort = transplant consideration

Question 8

All hepatitis types show?

Answer 8

Interface necrosis on histology