Samuel Douglas, Riordan Stephen, Strasser Simone, Kurtovic Jelica, Singh-Grewel Indira, Koorey David
AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, Sydney, Australia.
Clin Gastroenterol Hepatol. 2004 Jul;2(7):622-4. doi: 10.1016/s1542-3565(04)00245-9.
BACKGROUND & AIMS: 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.
We discuss a case series of 5 patients who developed severe AIH within 4 months post partum.
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.
AIH should be considered in the differential diagnosis of liver dysfunction first presenting in the early post partum period.
自身免疫性肝炎（AIH）若不治疗，可能会有侵袭性的临床病程。妊娠对AIH的影响各不相同。疾病活动期的发作和缓解，通常随后伴有产后发作，这是广为人知的。相比之下，产后早期首次出现明确的AIH尚未见报道。
我们讨论了一组5例产后4个月内发生严重AIH的病例。
根据国际公认的标准，AIH的诊断明确。所有患者的肝损伤对传统免疫抑制治疗均有反应。产后早期的免疫激活可能导致了这一情况。
对于产后早期首次出现肝功能障碍的鉴别诊断，应考虑AIH。
