title: Diagnosis and management of autoimmune hepatitis.
abstract: Autoimmune hepatitis is characterized by increased serum aminotransferase levels, autoantibodies, hypergammaglobulinemia, and interface hepatitis. Presentation can be acute, severe (fulminant), asymptomatic, or chronic. Diagnosis requires multiple findings and exclusion of similar diseases. Treatment with prednisone or prednisolone with azathioprine is recommended. Budesonide with azathioprine has normalized laboratory test with few side effects, but histologic resolution, durability of response, and target population are uncertain. Progressive worsening, incomplete improvement, drug intolerance, and relapse after drug withdrawal are suboptimal outcomes. Calcineurin inhibitors and mycophenolate mofetil are salvage agents in small series and liver transplantation is effective for liver failure.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address: czaja.albert@mayo.edu.
authors.forename: Albert J
authors.initials: AJ
authors.lastname: Czaja
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001323:Autoantibodies / Q000097:blood*; D004359:Drug Therapy, Combination; D019693:Hepatitis, Autoimmune / Q000175:diagnosis* / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016031:Liver Transplantation; D012008:Recurrence; D019233:Retreatment; D017211:Treatment Failure
chemical_list: D000893:Anti-Inflammatory Agents; D001323:Autoantibodies; D007166:Immunosuppressive Agents
keywords: Autoimmune; Diagnosis; Hepatitis; Salvage therapies; Steroids; Suboptimal responses