13 Questions
What is the main characteristic of autoimmune hepatitis?
Presence of serum antibodies and peripheral blood T lymphocytes reactive with self-proteins
Which type of autoimmune hepatitis is associated with antinuclear antibodies (ANAs) and anti-smooth muscle antibodies (ASMAs)?
Type 1 AIH
What is the prevalence of autoimmune hepatitis?
1%
Which antibodies are characteristic of Type 2 AIH?
Anti-liver-kidney microsomal-1 antibodies (anti-LKM1)
Which age range shows a bimodal distribution for autoimmune hepatitis?
10-20 years and 40-60 years
Which type of autoimmune hepatitis is most common in children?
Type 2
Which of the following autoimmune conditions is commonly associated with idiopathic autoimmune hepatitis?
Hashimoto thyroiditis
What are the common nonspecific symptoms of autoimmune hepatitis?
Fatigue, upper abdominal pain, weight loss
What signs may indicate acute liver failure in autoimmune hepatitis?
Jaundice, RUQ pain, fever
Which laboratory test results are typically elevated in autoimmune hepatitis?
Liver enzymes: ↑↑ ALT and ↑ AST
When should liver biopsy be performed to confirm the diagnosis of autoimmune hepatitis?
Following the detection of AIH antibodies
What is the first-line induction therapy for autoimmune hepatitis?
Prednisone with or without azathioprine
What is the 10-year survival rate with treatment for autoimmune hepatitis?
> 90%
Study Notes
Characteristics of Autoimmune Hepatitis
- The main characteristic of autoimmune hepatitis is the immune system's attack on the liver cells, causing inflammation and damage.
Type 1 Autoimmune Hepatitis
- Type 1 autoimmune hepatitis is associated with antinuclear antibodies (ANAs) and anti-smooth muscle antibodies (ASMAs).
Prevalence and Distribution
- The prevalence of autoimmune hepatitis is unknown, but it has a bimodal distribution, affecting mainly young women in their teens and twenties, and women in their fifties and sixties.
Type 2 Autoimmune Hepatitis
- Type 2 autoimmune hepatitis is characterized by the presence of liver-kidney microsomal antibodies (LMK-1) and liver cytosol antibodies (LC-1).
Autoimmune Hepatitis in Children
- Type 1 autoimmune hepatitis is the most common type in children.
Associated Conditions
- Idiopathic autoimmune hepatitis is often associated with other autoimmune conditions, such as rheumatoid arthritis, thyroiditis, and ulcerative colitis.
Symptoms and Signs
- Common nonspecific symptoms of autoimmune hepatitis include fatigue, loss of appetite, nausea, vomiting, and abdominal discomfort.
- Signs that may indicate acute liver failure include jaundice, dark urine, and pale stools.
Laboratory Tests
- Laboratory test results typically elevated in autoimmune hepatitis include transaminases (ALT and AST), gamma-globulins, and IgG levels.
Diagnosis
- Liver biopsy should be performed to confirm the diagnosis of autoimmune hepatitis, especially if laboratory tests are inconclusive.
Treatment
- The first-line induction therapy for autoimmune hepatitis is corticosteroids, which can induce remission in 80% of patients.
- With treatment, the 10-year survival rate for autoimmune hepatitis is around 90%.
Test your knowledge about autoimmune hepatitis, a disease characterized by immunemediated liver injury, serum antibodies, peripheral blood T lymphocytes, association with other autoimmune diseases, and high levels of serum immunoglobulins.
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