Gadour Eyad
Gastroenterology and Hepatology, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, GBR.
Cureus. 2021 Jun 16;13(6):e15682. doi: 10.7759/cureus.15682.
Autoimmune hepatitis (AIH) is an inflammatory pathology of the liver which leads to liver cirrhosis and death if left untreated and affects a large population across the world with no ethnic discrimination. AIH can be asymptomatic or with non-typical clinical presentation. The diagnosis and categorization of AIH are based on the presence of autoantibodies, specific biochemical indices, and histopathological features. The categorization of AIH further supports therapeutic management decisions. Associated comorbidities are another worrisome in treatment decisions and better outcomes. Liver transplantation is the ultimate choice in case of zero or minimal therapeutic response or severe liver damage. Liver transplantation also has its associated risks and rejection concerns. The international guidelines are designed to provide a complete management outline of AIH for better patient management. There is a disparity seen in these guidelines, especially in terms of dose recommendation. This review designed to lay out an overview of the new guidelines on the diagnosis and management of AIH.
自身免疫性肝炎(AIH)是一种肝脏炎症性病变,如果不进行治疗,会导致肝硬化和死亡,且在全球范围内影响大量人群,不存在种族歧视。AIH可能无症状或具有非典型临床表现。AIH的诊断和分类基于自身抗体的存在、特定生化指标和组织病理学特征。AIH的分类进一步支持治疗管理决策。合并症在治疗决策和更好的治疗结果方面也是另一个令人担忧的问题。在治疗反应为零或极小或肝脏严重受损的情况下,肝移植是最终选择。肝移植也有其相关风险和排斥问题。国际指南旨在为更好地管理患者提供AIH的完整管理大纲。这些指南存在差异,尤其是在剂量推荐方面。本综述旨在概述AIH诊断和管理的新指南。