[Autoimmune hepatitis]

Abstract

Autoimmune hepatitis (AIH) is chronic, predominantly periportal hepatitis with hypergammaglobulinemia and tissue autoantibodies. It is a relative rare disorder, with a preponderance of female patients, that can present at any age. Its diagnosis relies on the exclusion of viral, metabolic, genetic and toxic etiologies of chronic hepatitis or hepatic injury. There are no pathognomonic features, but the presence of antinuclear and smooth muscle antibodies or liver-kidney microsomal antibodies together with typical histological features in liver biopsy allows the diagnosis with good confidence. Corticosteroid therapy is effective in most patients. Because of a favorable side effect profile, the combination therapy with azathioprine should be used whenever possible. Relapses after initial treatment responses are frequent, but in the majority of patients the disease can be controlled. Liver transplantation is effective, and shows good 10-year survival rates.