Gastro - Autoimmune Hepatitis

Question 1

What are the two types of autoimmune hepatitis?

Answer 1

Type 1
Typically affects women in late forties or fifties

Presents around/after menopause with fatigue and features of liver disease

Type 2
Children or young people
Girls

Presents with acute hepatitis, high transaminases and jaundice

Question 2

What do LFTs show in autoimmune hepatitis?

Answer 2

High ALT
High AST
Normal/slightly raised ALP

Question 3

Asides from transaminases what else is an important finding in autoimmune hepatitis?

Answer 3

Raised IgG

Question 4

What are the autoantibodies in type 1 autoimmune hepatitis?

Answer 4

Anti-nuclear antibodies (ANA)
Anti-smooth muscle antibodies (anti-actin)
Anti-soluble liver antigen (anti-SLA/LP)

Question 5

What are the autoantibodies in type 2 autoimmune hepatitis?

Answer 5

Anti-liver kidney microsomes-1 (anti-LKM1)

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

Question 6

What does liver biopsy show in autoimmune hepatitis?

Answer 6

Interface hepatitis
Plasma cell infiltration

Question 7

How is autoimmune hepatitis managed?

Answer 7

Prednisolone
Azathioprine
Liver transplant (in end-stage liver disease)

Question 8

Can patients still suffer with autoimmune hepatitis after transplant?

Answer 8

Yes