Autoimmune Hepatitis Flashcards
What is Autoimmune Hepatitis (AIH)?
Chronic, progressive autoimmune disorder affecting the liver
AIH involves the immune system attacking liver cells, leading to inflammation and damage.
What are the autoantibodies associated with AIH?
- Antinuclear antibodies (ANA)
- Smooth muscle antibodies (SMA)
These autoantibodies help in the diagnosis of AIH.
What genetic factor is associated with AIH?
Genetic predisposition: HLA antigen alleles
Certain HLA alleles increase the risk of developing autoimmune diseases.
What is the sex prevalence for AIH?
FEMALE, link to sex hormones (F:M = 4:1)
The higher prevalence in females may be influenced by hormonal factors.
What are the age onset differences between Type 1 and Type 2 AIH?
- Type 1: 40-50 years
- Type 2: Childhood/young adult (girls)
This distinction helps in the diagnosis and management of the condition.
What are common underlying causes of AIH?
- Viral infection: Hep A, B, C, EBV
- Drugs: Minocycline, Nitrofurantoin, statins
- Environmental cause: Toxins/Chemicals
Identifying these causes is crucial for treatment and management.
What is the prevalence of Type 1 Autoimmune Hepatitis?
More common - 80% of all AIH
Type 1 AIH is significantly more prevalent than Type 2.
What autoantibodies are associated with Type 2 AIH?
LKM-1 and/or LC-1
These specific autoantibodies help differentiate Type 2 from Type 1 AIH.
What is a common histological finding in AIH?
- Interface hepatitis
- Lymphoplasmacytic infiltrate with rosette formation
- Hepatic fibrosis which can progress to cirrhosis
These findings are essential for confirming the diagnosis through liver biopsy.
What are some symptoms of Autoimmune Hepatitis?
- 25% asymptomatic
- Flu-like illness
- Jaundice
- Fatigue
- Anorexia
- Weight loss
- Abdominal pain
- Amenorrhoea
- Cirrhosis features: ascites, variceal bleeding
- Pruritus
- Arthralgias
- Pyrexia
- Maculopapular rash
Symptoms can vary widely among individuals.
What conditions are commonly seen alongside AIH?
- Coeliac Disease
- Thyroid
- T1DM
- UC
- RA
What is hypergammaglobulinemia?
Excess antibody production usually present in both types of AIH
This condition is indicative of an immune response in the body.
What blood findings are indicative of AIH?
- Raised transaminase levels for 3 months
- LFTs: raised **ALT, AST raised **and ALP normal/slightly raised
- Raised serum Immunoglobulins (IgG)
- Negative viral hepatitis tests
- **Autoantibodies: **ANA, anti-SMA
These findings assist in diagnosing AIH and differentiating it from other liver diseases.
What are some differential diagnoses for AIH?
- Alcoholic Liver Disease (ALD) - Alcohol Hx
- Non-alcoholic fatty liver disease (NAFLD) - No Autoantibodies
- Chronic hepatitis C infection - no serology
These conditions can present with similar symptoms and laboratory findings.
What is the first-line drug treatment for AIH to induce remission?
- Prednisolone (high dose steroids)
- Azathioprine (immunosupression)
Corticosteroids help reduce inflammation and immune response.
What are the immunosuppressive options for AIH remission managment?
- Azathioprine (Monotherapy)
- Mycophenolate Mofetil
These medications are used to maintain remission and prevent flare-ups.
What are common complications of AIH?
- Cirrhosis
- Complications associated with cirrhosis
- Iatrogenic complications related to steroids: osteoporosis, diabetes
Monitoring for these complications is crucial in managing patients with AIH.
Fill in the blank: Autoimmune Hepatitis is commonly associated with ______.
Coeliac disease, AI thyroid disease, T1DM, UC, Rheumatoid arthritis
These associations may complicate treatment and management of AIH.
