Severe autoimmune hepatitis first presenting in the early post partum period.
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.
Samuel
Douglas
D
AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, Sydney, Australia.
Riordan
Stephen
S
Strasser
Simone
S
Kurtovic
Jelica
J
Singh-Grewel
Indira
I
Koorey
David
D
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
D007166:Immunosuppressive Agents