Autoimmune liver disease Flashcards
what are the 3 types of autoimmune hepatitis?
type 1: anti-nuclear antibody (ANA)/ anti-smooth muscle antibodies (SMA)
- affects both children and adults
type 2: anti-liver/kidney microsomal type 1 antibodies (LKM1)
- only affects children
type 3: soluble liver/kidney antigen (SLA)
- affects middle aged adults
what are features of autoimmune hepatitis?
may present with signs of chronic liver disease
acute hepatitis: jaundice, pyrexia, RUQ pain (uncommon)
ammenorrhoea
ANA/SMA/LKM antibodies
raised IgG levels
how is autoimmune hepatitis diagnosed?
liver biopsy
- inflammation beyond the limiting plate ‘piecemeal necorosis’ and bridging necrosis
what is the management for autoimmune hepatitis?
steroids
+ immunosuppressant i.e. Azathioprine
liver transplantation
what is the management for primary biliary cholangitis?
ursodeoxycholic acid
what is the management for primary sclerosing cholangitis?
stenting
liver transplant
what is the difference in the pathophysiology of PSC and PBC?
PBC: granulomatou sinfmmation in the extrahepatic bile ducts
PSC: fibrosis/stricturing destroying bile ducts, intra and extra hepatic bile ducts