Autoimmune, PBC, PSC, DILI Flashcards
What is autoimmune hep?
Syndrome of progressive hep characterized by loss of tolerance to hepatic autoantigens
What autoabs is characteristic of autoimmune dis?
ANA
can see SMA, LP, LKM1 also
What does AIH co-occur with?
other autoimmune diseases like thyroid dis, Sicca syndrome
What is histologically characteristic for AIH?
lymphoplasmacytic infiltrate
How do you treat AIH?
Steroids and azathioprine
What is primary biliary cirrhosis
Chronic inflammation and destruction of interlobular and septal bile ducts leading to chronic cholestasis and biliary cirrhosis (maybe)
What autoAb is seen in PBC?
AMA
Who gets PBC M or F?
F
What lab is elevated in PBC?
alk phos (that with AMA is enough to diagnose)
What is PBC histo
noncaseating granuloma, inflammation, destruction of intrahepatic ducts, small bile duct disease
How do you treat PBC
Ursodiol
What are some side effects to PBC
- pruritus
- fatigue
- jaundice
- xanthelasma
- vitiligo
What do we do with hypercholes in PBC
nothing, TGs arent circulating so its fine
What is primary sclerosing cholangitis?
Chronic cholestatic liver disease of unknown etiology characterized by inflammation and fibrosis of biliary tree. Ie large duct disease
Who gets PSC? M or F?
M
What ERCP/MRCP finding is consistent with PSC?
Beads on a string
How do we get PBC?
Abnormal presentation of pyruvate dehydrogenase–>biliary epithelial cell death
What imaging dont you want to do with PSC?
ERCP because ducts are dilated and can cause infection
What is PSC associated with ?
UC, inc risk of colon cancer
Histology of PSC?
- onion skin fibrosis
- biliary sludge
- loss of bile ducts
What drugs can cause intrinsic DILI? (drug induced liver disease)
Acetaminophen and methotrexate
ie predictable with dose etc
What drugs can cause idosyncratic DILI?
Augmentin, statins
ie unpredictable
