title: Diagnosis and therapy of autoimmune hepatitis.
abstract: Autoimmune hepatitis (AIH) is a chronic progressive hepatitis, characterized by interface hepatitis with lymphoplasmacellular infiltrates on liver biopsy, high serum globulin level and circulating autoantibodies. It is classified into two types, according to autoantibody profile: type 1 is characterized by anti-nuclear (ANA) and/or anti-smooth muscle (SMA) antibodies; type 2 by anti-liver kidney microsomal type 1 (anti-LKM-1) antibodies. AIH affects all ages, may be asymptomatic, frequently has an acute onset, and can present as fulminant hepatitis. The diagnosis of AIH is based on a scoring system codified by an international consensus. Corticosteroids alone or in conjunction with azathioprine is the treatment of choice in patients with AIH and results in remission induction in over 80% of patients. Alternative proposed strategies in patients who have failed to achieve remission on standard therapy or patients with drug toxicity include the use of cyclosporine, tacrolimus, budesonide or mycophenolate mofetil. Liver transplantation is the treatment of choice in managing decompensated disease, however AIH can recur or develop de novo after liver transplantation.
authors.affiliation: Dipartimento di Medicina Clinica, Alma Mater Studiorum University of Bologna, S.Orsola-Malpighi Hospital, Padiglione 11, Via Massarenti 9, 40138, Bologna. alessandro.granito@unibo.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Granito
authors.forename: Paolo
authors.initials: P
authors.lastname: Muratori
authors.forename: Silvia
authors.initials: S
authors.lastname: Ferri
authors.forename: Georgios
authors.initials: G
authors.lastname: Pappas
authors.forename: Chiara
authors.initials: C
authors.lastname: Quarneti
authors.forename: Marco
authors.initials: M
authors.lastname: Lenzi
authors.forename: Francesco B
authors.initials: FB
authors.lastname: Bianchi
authors.forename: Luigi
authors.initials: L
authors.lastname: Muratori
mesh_terms: D000818:Animals; D019693:Hepatitis, Autoimmune / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000737:chemistry / Q000276:immunology / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents