Verwer Bart J, Bouma Gerd, Bloemena Elisabeth, Schreuder Tim C M A, Mulder Chris J J, van Nieuwkerk Karin M J
VU medisch centrum, Amsterdam, The Netherlands.
Ned Tijdschr Geneeskd. 2009;153:A247.
Autoimmune hepatitis (AIH) is a progressive, chronic form of hepatitis of unknown cause that occurs in people of all ages. The diagnosis is based on characteristic clinical and biochemical abnormalities, absence of other causes of hepatitis and histopathological characteristics. The variety of symptoms that AIH patients may have and the importance of considering the disease is illustrated in three case studies. The first was a 22-year-old woman with fulminant hepatitis and jaundice. Corticosteroid and azathioprine treatment resulted in prolonged remission. The second patient, a 48-year-old woman, had hepatocellular carcinoma in a cirrhotic liver, based on AIH. Radiofrequency ablation was planned, after which the patient would be put on the waiting list for transplantation. The third patient was an 81-year-old man with impaired liver function and cirrhosis. His treatment was the same as in the first patient and resulted in remission as well. No curative therapy for AIH is yet available, but appropriate management of the disease can prolong survival, improve the quality of life, and avoid the need for liver transplantation.
自身免疫性肝炎（AIH）是一种病因不明的进行性慢性肝炎，可发生于各年龄段人群。诊断基于特征性的临床和生化异常、无其他肝炎病因以及组织病理学特征。三个病例研究说明了AIH患者可能出现的各种症状以及考虑该疾病的重要性。第一个病例是一名22岁患有暴发性肝炎和黄疸的女性。皮质类固醇和硫唑嘌呤治疗使病情长期缓解。第二个患者是一名48岁女性，基于自身免疫性肝炎，其肝硬化肝脏中发生了肝细胞癌。计划进行射频消融，之后该患者将被列入肝移植等待名单。第三个患者是一名81岁肝功能受损和肝硬化的男性。他的治疗与第一个患者相同，也取得了缓解。目前尚无治愈自身免疫性肝炎的疗法，但对该疾病进行适当管理可延长生存期、提高生活质量并避免肝移植的需求。
