Background: Autoimmune hepatitis (AIH) is a hepatocyte injury characterized\nby a dis-regulated immune system, inflammation of the liver with interface\nhepatitis, serum antibodies and elevated gamma-globulins. Currently, it\nexists 2 mainly types on autoimmune hepatitis, based on the presentation of\ntheir autoantibodies: type 1 and 2. Type 1 is the one of interest in this review.\nAutoimmune hepatitis type 1 is an indolent inflammatory disease mediated by\nabnormal autoimmune reaction, commonly seeing in women (4:1), with no\npreference of age, however typically present in 4th and 6th decade�s individuals,\nand a good response to immunosuppressive therapy. Autoimmune hepatitis\nis known to present not specific symptoms which can go from inexistent to\nfulminant or exacerbate presentation. The incidence of autoimmune hepatitis\nin western country is 1/5000 - 1/10,000. Although the detection rate of AIH\nincreasing, especially in China, autoimmune hepatitis diagnosis and treatment\nremain challenging. Most AIH case do not present pathognomonic biomarkers,\nhowever the diagnostic has to considerate other features, which had been\ncodified into validated diagnosis scoring systems. Regarding the treatment,\nbased on prior literature autoimmune hepatitis is mostly sensitive to prednisone\nor azathioprine, however the use of other immunosuppressive agent or\nevent their combination had offer distinct advantages. Autoimmune hepatitis\npresents a great life threatening disorder especially because of the delay in the\nearly stage on the disease, the not specific presentations, and the large overlap\nsyndrome associate with it. A deep knowledge in its identification, specific\ndiagnostic criteria, and its therapeutic strategy is much needed. Conclusion:\nAutoimmune hepatitis is a systemic disease that is difficult to recognize because\nof its variable clinical presentation and histological features that are not\nstrictly specific. Several new autoantibodies as well as recently simplified diagnostic\ncriteria may allow the primary care physician to progress in the diagnostic\nprocess. This is all the more important as undiagnosed and therefore untreated autoimmune hepatitis has a poor prognosis and immunosuppressive\ntreatment leads to remission in a large majority of cases.
Loading....