Autoimmune Hepatitis

Autoimmune hepatitis is a combination of genetic susceptibility and environmental factors, leading to the breakdown of autoimmune tolerance, thereby causing the autoimmune response against liver cells and leading to liver cell damage. The onset of autoimmune hepatitis is slow, and the mild cases are asymptomatic, and symptoms such as fatigue, abdominal distension, lack of appetite, itching, jaundice, splenomegaly, and spider nevus appear during the activity of the disease. The disease is clinically characterized by varying degrees of elevated serum transaminase, hyper γ-globulinemia, positive autoantibody, and histological features that are interfacial hepatitis dominated by lymphocyte and plasma cell infiltration. Severe cases can quickly progress to cirrhosis and liver failure. The treatment of autoimmune hepatitis is based on drug immunotherapy.

Diagnosis of Autoimmune Hepatitis

The diagnosis methods of autoimmune hepatitis mainly include the following:

• Physical examination. Skin mucosa examination is performed to observe whether there exists jaundice, petechiae, petechiae, and edema of the limbs. Abdominal physical examination for liver enlargement, splenomegaly, liver tenderness, spleen tenderness, etc.
• Serum biochemical examination. The patient's alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are elevated.
• Immunological examination. γ-globulin is elevated, and autoantibodies are detected in the blood circulation, including antinuclear antibodies (ANA), anti-smooth muscle antibodies (SMA), anti-neutrophil plasma antibodies (pANCA), and anti-soluble liver antigen antibodies (anti-SLA) /anti-liver pancreatic antibody (anti-LP), anti-actin antibody (anti-actin), anti-liver kidney microsomal antibody (anti-LKM1), etc.
• Imaging examination. Abdominal ultrasound has a good diagnostic significance for patients with autoimmune hepatitis progressing to cirrhosis.
• Liver biopsy. Perform a liver biopsy to confirm the diagnosis and to determine the degree and type of liver damage.

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Reference

1. Czaja A J. (2016). "Diagnosis and management of autoimmune hepatitis: current status and future directions." Gut and liver. 10.2: 177.