Autoimmune hepatitis

Question 1

What is autoimmune hepatitis also known as?

Answer 1

Lupoid hepatitis (causes lupus-like rash)

Question 2

In autoimmune hepatitis the adaptive immune system mounts an autoimmune response against ______

Answer 2

hepatocytes

Question 3

Is autoimmune hepatitis common?

Answer 3

No very rare

Question 4

What are risk factors for autoimmune hepaitis?

Answer 4

Female
Other autoimmune diseases eg SLE
Viral hepatitis
HLA DR3 or DR4

Question 5

All hepatitis types show i______ n_____ on histology

Answer 5

interface necrosis
(also known as piecemeal necrosis - is inflammation from portal tract into periportal zone)

Question 6

How many types of autoimmune hepatitis are there?

Answer 6

2

Question 7

What group of people does autoimmune hepatitis predominantly affect?

Answer 7

Adult females (80% cases)

Question 8

What 2 antibodies are present in autoimmune hepatitis type 1?

Answer 8

ANA (antinuclear antibody)
ASMA (anti-smooth muscle antibody)

Question 9

What group of people does autoimmune hepatitis type 2 predominantly affect?

Answer 9

Young females (rarer)

Question 10

What 2 antibodies can be present in type 2 autoimmune hepatitis?

Answer 10

anti-LKM-1 (anti-liver-kidney microsome type 1)
anti-LC1 (anti-liver cytosol type 1)

Question 11

What are symptoms of autoimmune hepatitis?

Answer 11

25% asymptomatic
Many:
Jaundice
Fever
Hepatosplenomegaly

Question 12

How is autoimmune hepatitis diagnosed?

Answer 12

Serology (ANA, ASMA or ALC-1, ALKM1)

Question 13

What is treatment for autoimmune hepatitis?

Answer 13

Corticosteroids (prednisolone)
Azathioprine
Hep A and B vaccination

last resort = liver transplant consideration