autoimmune hepatitis

Question 1

who typically gets type 1 and type 2 AI hepatitis?

Answer 1

Type 1= middle aged women

Type 2= children (more common in girls)

Question 2

how does the presentation differ in type 1 and type 2 AI hepatitis?

Answer 2

Type 2 is a lot more acute than type 1

Type 1= fatigue + features of liver disease

Type 2= presents with acute hepatitis

Question 3

key findings on LFTs and bloods in AI hepatitis?

Answer 3

show a hepatic picture on LFTS:
-raised ALT + AST (transamerases)
-little raise in ALP

Raised IgG

Antibodies

Question 4

what antibodies are seen in type 1 autoimmune hepatitis?

Answer 4

Anti-nuclear antibody (ANA)

Anti-smooth muscle antibodies (anti-actin)

Anti-soluble liver antigen (anti-SLA/LP)

Question 5

what antibodies are seen in type 2 autoimmune hepatitis?

Answer 5

anti-liver kidney microsome 1 (anti-LKM1)

Anti-liver cytosol antigen type 1 (anti-LC1)

Question 6

mangement of autoimmune hepatitis?

Answer 6

1st line= high dose prednisolone

2nd line= add azathioprine

if end stage liver disease= liver transplant (however AI hepatitis can also occur with new liver)