自身免疫性肝炎
医学
硫唑嘌呤
无症状的
疾病
肝炎
自身抗体
肝病
免疫学
内科学
抗体
作者
George Ν. Dalekos,Anna Samakidou,Aggeliki Lyberopoulou,Eleni Banakou,Nikolaos Gatselis
出处
期刊:Polskie Archiwum Medycyny Wewnetrznej-polish Archives of Internal Medicine
日期:2022-09-07
被引量:6
摘要
Autoimmune hepatitis (AIH) is an acute or chronic inflammatory disease of the liver caused by an immune response of unknown origin. It affects people from all ethnic groups irrespective of age or sex. AIH is characterized by hyperglobulinemia, presence of circulating autoantibodies, and liver inflammation. The clinical picture of the disease varies from asymptomatic or mild to severe acute hepatitis or liver failure. A timely and prompt diagnosis is of utmost importance to prevent progression to advanced liver disease by immediate initiation of immunosuppressive treatment. So far, several diagnostic scoring systems have been proposed, which incorporated demographic data as well as biochemical, clinical, and histological characteristics of the disease. However, due to the high heterogeneity of the disease presentation, diagnosis of AIH remains challenging. Most patients initially respond to first‑ line treatment, which consists of corticosteroids combined with azathioprine or mycophenolate mofetil. However, insufficient response to the treatment and intolerance due to side effects are common, so a significant proportion of patients require second- and / or third‑ line therapies. Herein, we review the challenges and recent advances in AIH diagnosis and management.
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