title: Severe autoimmune hepatitis first presenting in the early post partum period.
abstract: OBJECTIVE
  Autoimmune hepatitis (AIH) may run an aggressive clinical course if untreated. The influence of pregnancy on AIH is variable. Both flares in disease activity and remissions, often followed by a post partum flare, are well recognized. In contrast, definite AIH first presenting in the early post partum period has not been reported.
  
  
  METHODS
  We discuss a case series of 5 patients who developed severe AIH within 4 months post partum.
  
  
  RESULTS
  The diagnosis of AIH was definite based on internationally accepted criteria. Liver injury responded to conventional immunosuppressive therapy in all patients. Immune reactivation in the early post partum period may contribute to this entity.
  
  
  CONCLUSIONS
  AIH should be considered in the differential diagnosis of liver dysfunction first presenting in the early post partum period.
authors.affiliation: AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, Sydney, Australia.
authors.forename: Douglas
authors.initials: D
authors.lastname: Samuel
authors.forename: Stephen
authors.initials: S
authors.lastname: Riordan
authors.forename: Simone
authors.initials: S
authors.lastname: Strasser
authors.forename: Jelica
authors.initials: J
authors.lastname: Kurtovic
authors.forename: Indira
authors.initials: I
authors.lastname: Singh-Grewel
authors.forename: David
authors.initials: D
authors.lastname: Koorey
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D019693:Hepatitis, Autoimmune / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008111:Liver Function Tests; D049590:Postpartum Period; D011247:Pregnancy; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents