Auto immune hepatitis

• Published in: World journal of gastroenterology : WJG Vol. 22; no. 19; pp. 4651 - 4661
• Main Authors: van Gerven, Nicole Mf, de Boer, Ynto S, Mulder, Chris Jj, van Nieuwkerk, Carin Mj, Bouma, Gerd
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 21.05.2016
• Subjects: Animals; Auto; Disease Progression; Genetic Predisposition to Disease; Hepatitis, Autoimmune - diagnosis; Hepatitis, Autoimmune - drug therapy; Hepatitis, Autoimmune - epidemiology; hepatitis;Diagnosis;Liver;Epidemiology;Treatment; Humans; immune; Immunosuppressive Agents - therapeutic use; Predictive Value of Tests; Recurrence; Remission Induction; Review; Risk Factors; Severity of Illness Index; Treatment Outcome; Auto immune hepatitis; Treatment; Diagnosis; Epidemiology; Liver
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v22.i19.4651

To provide an update of the latest trends in epidemiology, clinical course, diagnostics, complications and treatment of auto immune hepatitis(AIH). A search ofthe MEDLINE database was performed using the search terms: "auto immune hepatitis", "clinical presentation", "symptoms", "signs", "diagnosis", "auto antibodies", "laboratory values", "serology", "histopathology", " h i s t o l o g y ", " g e n e t i c s ", "HLA g e n e s ", "non-HLA genes", "environment", "epidemiology", "prevalence", "incidence", "demographics", "complications", "HCC", "PBC", "PSC", "corticosteroid", "therapy", "treatment", "alternative treatment". English-language full-text articles and abstracts were considered. Articles included reviews, meta-analysis, prospective retrospective studies. No publication date restrictions were applied. AIH is an immune meditated progressive inflammatory liver disease that predominantly affects middle-aged females but may affect people of all ages. The clinical spectrum of AIH is wide, ranging from absent or mild symptoms to fulminant hepatic failure. The aetiology of AIH is still unknown, but is believed to occur as the consequence of an aberrant immune response towards an un-known trigger in a genetically susceptible host. In the absence of a gold standard, diagnosis is based on the combination of clinical, biochemical and histopathological criteria. Immunosuppressive treatment has been the cornerstone of treatment since the earliest description of the disease in 1950 by Waldenstr?m. Such treatment is often successful at inducing remission and generally leads to normal life expectancy. Nevertheless, there remain significant areas of unmet aetiological a clinical needs including fundamental insight in disease pathogenesis, optimal therapy, duration of treatment and treatment alternatives in those patients unresponsive to standard treatment regimens.