Overview

• Autoimmune Hepatits → chronic inflammatory disease of the liver of unknown aetiology. Commonly affects young females.

  • Type 1 AIH (Most Common - 80%) → antinuclear antibodies (ANA) and anti-smooth muscle antibodies (ASMA). Occurs in children and adults.
  • Type 2 AIH → anti-liver-kidney microsomal-1 antibodies (anti-LKM-1). Affects children only.
  • Type 3 AIH → anti-soluble liver antigen

• Aetiology → idiopathic, commonly associated with other autoimmune conditions (eg. hashimoto’s, grave’s, UC, coeliac disease). HLA gene plays a role.

• Ischaemic Hepatitis → can occur following acute hepatic hypoperfusion. Characterised by marked elevation of AST and ALT levels 1-3 days after insult. Also causes significant rise in LDH (very sensitive for ischaemic hepatitis).

• Hepatitis (Distinguishing Features)

Making Diagnosis

Clinical Features:

• Hepatomegaly
• Jaundice
• Amenorrhoea
• Pruritus
• Spider Angiomata
• Ascites
• Splenomegaly
• Nausea