https://wikem.org/w/index.php?action=history&feed=atom&title=Autoimmune_hepatitis%2Fen 2026-04-17T18:06:16Z Revision history for this page on the wiki MediaWiki 1.38.2 https://wikem.org/w/index.php?title=Autoimmune_hepatitis/en&diff=380321&oldid=prev 2026-01-06T21:37:04Z

<p>Updating to match new version of source page</p> <p><b>New page</b></p><div>&lt;languages/&gt;<br /> <br /> ==Background==<br /> <br /> *Hepatocellular inflammation caused by autoimmune pathology, ultimately leading to necrosis and cirrhosis<br /> *Presentation may be acute or chronic, rarely presents as fulminant [[Special:MyLanguage/hepatic failure|hepatic failure]]<br /> *Usually affects women (~70%&lt;ref&gt;http://www.liverfoundation.org/abouttheliver/info/aihep/&lt;/ref&gt; between age 15-40 years<br /> *Often occurs comorbidly with other autoimmune disorders (e.g. type 1 [[Special:MyLanguage/diabetes|diabetes]], [[Special:MyLanguage/thyroid disease|thyroid disease]], [[Special:MyLanguage/inflammatory bowel disease|inflammatory bowel disease]], [[Special:MyLanguage/Sjögren|Sjögren]]'s)<br /> *3 subtypes of autoimmune hepatitis: types 1-3, with type 1 being the most common<br /> <br /> <br /> ==Clinical Features==<br /> <br /> [[File:Jaundice08.jpg|thumb|Jaundice of the skin]]<br /> [[File:Jaundice.jpg|thumb|Pediatric jaundice with icterus of sclera.]]<br /> ''Findings of liver disease and systemic signs/symptoms of autoimmune disorders''<br /> *[[Special:MyLanguage/Nausea/vomiting|Nausea/vomiting]], diarrhea<br /> *[[Special:MyLanguage/Epigastric pain|Epigastric pain]], [[Special:MyLanguage/RUQ pain|RUQ pain]]<br /> *Anorexia<br /> *[[Special:MyLanguage/Jaundice|Jaundice]]<br /> *[[Special:MyLanguage/Ascites|Ascites]], [[Special:MyLanguage/SBP|SBP]], edema<br /> *[[Special:MyLanguage/Pruritus|Pruritus]]<br /> *[[Special:MyLanguage/Fatigue|Fatigue]], malaise, [[Special:MyLanguage/weakness|weakness]]<br /> *[[Special:MyLanguage/Arthralgia|Arthralgia]], myalgia<br /> *Spider angiomata, hirsutism, amenorrhea<br /> *[[Special:MyLanguage/Chest pain|Chest pain]] due to pleuritis<br /> *Weight loss<br /> *[[Special:MyLanguage/hepatomegaly|Hepatosplenomegaly]]<br /> *[[Special:MyLanguage/Hepatic encephalopathy|Hepatic encephalopathy]]<br /> *[[Special:MyLanguage/liver disease induced coagulopathy|Coagulopathy]]<br /> *[[Special:MyLanguage/GI bleed|GI bleed]]<br /> <br /> <br /> ==Differential Diagnosis==<br /> <br /> *[[Special:MyLanguage/Viral hepatitis|Viral hepatitis]]<br /> *[[Special:MyLanguage/Acute alcoholic hepatitis|Acute alcoholic hepatitis]], alcoholic liver disease<br /> *[[Special:MyLanguage/Acetaminophen toxicity|Acetaminophen toxicity]] and other drug-induced hepatotoxicity (<br /> *[[Special:MyLanguage/Mushroom toxicity|Mushroom toxicity]]<br /> *[[Special:MyLanguage/Ischemic hepatitis|Ischemic hepatitis]]<br /> *[[Special:MyLanguage/Non-alcoholic steatohepatitis|Non-alcoholic steatohepatitis]]<br /> *Cardiac cirrhosis<br /> *Primary biliary cirrhosis<br /> *[[Special:MyLanguage/primary sclerosing cholangitis|primary sclerosing cholangitis]]<br /> *[[Special:MyLanguage/Budd-Chiari|Budd-Chiari]]<br /> *Alpha1 anti-trypsin Deficiency<br /> *[[Special:MyLanguage/Cystic Fibrosis|Cystic Fibrosis]]<br /> *[[Special:MyLanguage/Wilson's disease|Wilson's disease]]<br /> *[[Special:MyLanguage/Sarcoidosis|Sarcoidosis]]<br /> <br /> {{Acute hepatitis causes}}<br /> <br /> {{Hepatomegaly DDX}}<br /> <br /> <br /> ==Evaluation==<br /> <br /> <br /> ===Workup===<br /> <br /> *[[Special:MyLanguage/LFTs|LFTs]]<br /> **ALT/AST 1.5-50 times normal<br /> **Mild to moderate elevations in bilirubin and alk phos<br /> *CBC<br /> **+/- mild [[Special:MyLanguage/leukopenia|leukopenia]],<br /> **+/- normocytic or hemolytic [[Special:MyLanguage/anemia|anemia]]<br /> **+/- [[Special:MyLanguage/thrombocytopenia|thrombocytopenia]]<br /> *BMP: evaluate for electrolyte derangements, [[Special:MyLanguage/hypoglycemia|hypoglycemia]], [[Special:MyLanguage/hepatorenal syndrome|hepatorenal syndrome]]<br /> *PT/INR<br /> *Ammonia if suspect [[Special:MyLanguage/hepatic encephalopathy|hepatic encephalopathy]]<br /> *[[Special:MyLanguage/Paracentesis|Paracentesis]] if suspect [[Special:MyLanguage/SBP|SBP]]<br /> *Consider [[Special:MyLanguage/RUQ ultrasound|RUQ ultrasound]] and/or MRCP<br /> <br /> <br /> ===Diagnosis===<br /> <br /> *Evaluate for other causes of liver disease, if not previously diagnosed with autoimmune hepatitis:<br /> **[[Special:MyLanguage/Viral hepatitis|Viral hepatitis]] serologies<br /> **[[Special:MyLanguage/Acetaminophen|Acetaminophen]] level<br /> *Autoantibodies: may have positive ANA, SMA, LKM-1, and/or anti-LC1&lt;ref&gt;http://emedicine.medscape.com/article/172356-overview&lt;/ref&gt; ; ANA &amp; SMA usually positive in type 1 autoimmune hepatitis, LJM-1 and atypical p-ANCA positive in type 2 and liver soluble antigen usually in type 3<br /> *Definitive diagnosis usually by liver biopsy<br /> <br /> <br /> ==Management==<br /> <br /> *[[Special:MyLanguage/Corticosteroids|Corticosteroids]] +/- [[Special:MyLanguage/Azathioprine|Azathioprine]]<br /> *Manage complications, see:<br /> **[[Special:MyLanguage/Ascites|Ascites]], [[Special:MyLanguage/SBP|SBP]]<br /> **[[Special:MyLanguage/Upper gastrointestinal bleed|Upper gastrointestinal bleed]]<br /> **[[Special:MyLanguage/Hepatorenal syndrome|Hepatorenal syndrome]]<br /> **[[Special:MyLanguage/Hepatic encephalopathy|Hepatic encephalopathy]]<br /> *Ultimately, may require transplant<br /> *Hepatology/Gastroenterology consult should be made<br /> <br /> <br /> ==Disposition==<br /> <br /> <br /> ==See Also==<br /> <br /> *[[Special:MyLanguage/Acute hepatitis|Acute hepatitis]]<br /> *[[Special:MyLanguage/Cirrhosis|Cirrhosis]]<br /> <br /> <br /> ==External Links==<br /> <br /> <br /> ==References==<br /> <br /> &lt;references/&gt;<br /> <br /> [[Category:GI]]</div>

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