Autoimmune Hepatitis

Question 1

Demographic most likely to develop autoimmune hepatitis

Answer 1

young females

Question 2

Three types autoimmune hepatitis

Answer 2

Type I:
- Anti-nuclear antibodies (ANA) and/or anti-smooth muscle antibodies (SMA)
> Affects both adults and children

Type II:
- Anti-liver/kidney microsomal type 1 antibodies (LKM1)
> Affects children only

Type III:
- Soluble liver-kidney antigen
> Affects adults in middle-age

Question 3

Clinical features of autoimmune hepatitis

Answer 3

• signs of chronic liver disease
• acute hepatitis: fever, jaundice (only 25% present in this way)
• amenorrhoea

Question 4

What antibodies can be found in autoimmune hepatitis?

Answer 4

ANA/SMA/LKM1 antibodies, raised IgG levels

Question 5

Describe how autoimmune hepatitis would appear on liver biopsy

Answer 5

• inflammation extending beyond limiting plate
• ‘piecemeal necrosis’
• bridging necrosis

Question 6

Management of autoimmune hepatitis

Answer 6

• steroids
• other immunosuppressants e.g. azathioprine
• liver transplantation