Epidemiology and treatment of autoimmune hepatitis

Sven Francque1,2, Luisa Vonghia1,3, Albert Ramon1,4, Peter Michielsen1,21Antwerp University Hospital, Department of Gastroenterology Hepatology, Antwerp, Belgium; 2Antwerp University, Faculty of Medicine and Health Sciences, Laboratory of Experimental Medicine and Paediatrics, Antwerp, Belgium; 3Dep...

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Autores principales:	Francque S, Vonghia L, Ramon A, Michielsen P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/4616c9fee2c940abbe2b846744e4956d
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spelling	oai:doaj.org-article:4616c9fee2c940abbe2b846744e4956d2021-12-02T00:09:19ZEpidemiology and treatment of autoimmune hepatitis1179-1535https://doaj.org/article/4616c9fee2c940abbe2b846744e4956d2012-03-01T00:00:00Zhttp://www.dovepress.com/epidemiology-and-treatment-of-autoimmune-hepatitis-a9512https://doaj.org/toc/1179-1535Sven Francque1,2, Luisa Vonghia1,3, Albert Ramon1,4, Peter Michielsen1,21Antwerp University Hospital, Department of Gastroenterology Hepatology, Antwerp, Belgium; 2Antwerp University, Faculty of Medicine and Health Sciences, Laboratory of Experimental Medicine and Paediatrics, Antwerp, Belgium; 3Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari, Italy; 4Institute and Laboratory for Genetic Diseases and Molecular Biology, Cologne, GermanyAbstract: Autoimmune hepatitis (AIH) is a chronic inflammatory disease of the liver that occurs worldwide with a low and probably underestimated prevalence. Although it typically affects young and middle-aged women, it can occur in both sexes and across all age groups. AIH runs a fluctuating course, but can present as severe and even fulminant hepatic failure or at a stage of advanced fibrosis or cirrhosis. Prognosis of severe AIH is poor if untreated. The pathogenesis is complex, combining environmental factors (external chemical or infectious triggers) and host genetic susceptibility. The diagnosis is based, after exclusion of other etiologies of chronic liver disease, on a combination of different elements, including the presence of elevated transaminases, elevated immunoglobulin G (IgG) levels, the presence and pattern of typical autoantibodies, and a liver biopsy showing interface hepatitis and other characteristic features. No single test can be used to make the diagnosis. Response to treatment can also help to establish the diagnosis. Simplified criteria can be used to make a bedside diagnosis with relatively high accuracy. Treatment consists of corticosteroids or other immunosuppressive regimens according to the severity of the disease, the response to the treatment, and the tolerance to therapy, with liver transplantation as an ultimate remedy in treatment-resistant cases with liver decompensation.Keywords: autoimmune hepatitis, antibodies, pathophysiology, treatment, epidemiologyFrancque SVonghia LRamon AMichielsen PDove Medical PressarticleDiseases of the digestive system. GastroenterologyRC799-869ENHepatic Medicine: Evidence and Research, Vol 2012, Iss default, Pp 1-10 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Diseases of the digestive system. Gastroenterology RC799-869 Francque S Vonghia L Ramon A Michielsen P Epidemiology and treatment of autoimmune hepatitis
description	Sven Francque1,2, Luisa Vonghia1,3, Albert Ramon1,4, Peter Michielsen1,21Antwerp University Hospital, Department of Gastroenterology Hepatology, Antwerp, Belgium; 2Antwerp University, Faculty of Medicine and Health Sciences, Laboratory of Experimental Medicine and Paediatrics, Antwerp, Belgium; 3Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari, Italy; 4Institute and Laboratory for Genetic Diseases and Molecular Biology, Cologne, GermanyAbstract: Autoimmune hepatitis (AIH) is a chronic inflammatory disease of the liver that occurs worldwide with a low and probably underestimated prevalence. Although it typically affects young and middle-aged women, it can occur in both sexes and across all age groups. AIH runs a fluctuating course, but can present as severe and even fulminant hepatic failure or at a stage of advanced fibrosis or cirrhosis. Prognosis of severe AIH is poor if untreated. The pathogenesis is complex, combining environmental factors (external chemical or infectious triggers) and host genetic susceptibility. The diagnosis is based, after exclusion of other etiologies of chronic liver disease, on a combination of different elements, including the presence of elevated transaminases, elevated immunoglobulin G (IgG) levels, the presence and pattern of typical autoantibodies, and a liver biopsy showing interface hepatitis and other characteristic features. No single test can be used to make the diagnosis. Response to treatment can also help to establish the diagnosis. Simplified criteria can be used to make a bedside diagnosis with relatively high accuracy. Treatment consists of corticosteroids or other immunosuppressive regimens according to the severity of the disease, the response to the treatment, and the tolerance to therapy, with liver transplantation as an ultimate remedy in treatment-resistant cases with liver decompensation.Keywords: autoimmune hepatitis, antibodies, pathophysiology, treatment, epidemiology
format	article
author	Francque S Vonghia L Ramon A Michielsen P
author_facet	Francque S Vonghia L Ramon A Michielsen P
author_sort	Francque S
title	Epidemiology and treatment of autoimmune hepatitis
title_short	Epidemiology and treatment of autoimmune hepatitis
title_full	Epidemiology and treatment of autoimmune hepatitis
title_fullStr	Epidemiology and treatment of autoimmune hepatitis
title_full_unstemmed	Epidemiology and treatment of autoimmune hepatitis
title_sort	epidemiology and treatment of autoimmune hepatitis
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/4616c9fee2c940abbe2b846744e4956d
work_keys_str_mv	AT francques epidemiologyandtreatmentofautoimmunehepatitis AT vonghial epidemiologyandtreatmentofautoimmunehepatitis AT ramona epidemiologyandtreatmentofautoimmunehepatitis AT michielsenp epidemiologyandtreatmentofautoimmunehepatitis
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Epidemiology and treatment of autoimmune hepatitis

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