RT Book, Section
A1 Dienstag, Jules L.
A2 Jameson, J. Larry
A2 Fauci, Anthony S.
A2 Kasper, Dennis L.
A2 Hauser, Stephen L.
A2 Longo, Dan L.
A2 Loscalzo, Joseph
SR Print(0)
ID 1178426963
T1 Autoimmune Hepatitis
T2 Harrison's Principles of Internal Medicine, 20e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259644016
LK accesspharmacy.mhmedical.com/content.aspx?aid=1178426963
RD 2024/04/18
AB Autoimmune  hepatitis  is  a  chronic  disorder  characterized  by  continuing  hepatocellular  necrosis  and  inflammation,  usually  with  fibrosis,  which  can  progress  to  cirrhosis  and  liver  failure.  When  fulfilling  criteria  of  severity,  this  type  of  chronic  hepatitis,  when  untreated,  may  have  a  6-month  mortality  of  as  high  as  40%.  Based  on  contemporary  estimates  of  the  natural  history  of  autoimmune  hepatitis,  the  10-year  survival  is  80−98%  for  treated  and  67%  for  untreated  patients.  The  prominence  of  extrahepatic  features  of  autoimmunity  and  seroimmunologic  abnormalities  in  this  disorder  supports  an  autoimmune  process  in  its  pathogenesis;  this  concept  is  reflected  in  the  prior  labels  lupoid  and  plasma  cellhepatitis.  Autoantibodies  and  other  typical  features  of  autoimmunity,  however,  do  not  occur  in  all  cases;  among  the  broader  categories  of  “idiopathic”  or  cryptogenic  chronic  hepatitis,  many,  perhaps  the  majority,  are  probably  autoimmune  in  origin.  Cases  in  which  hepatotropic  viruses,  metabolic/genetic  derangements  (including  nonalcoholic  fatty  liver  disease),  and  hepatotoxic  drugs  have  been  excluded  represent  a  spectrum  of  heterogeneous  liver  disorders  of  unknown  cause,  a  proportion  of  which  are  most  likely  autoimmune  hepatitis.