Weltzsch Jan Philipp, Ziegler Annerose, Lohse Ansgar
I. Med. Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
Inn Med (Heidelb). 2023 Jul;64(7):655-667. doi: 10.1007/s00108-023-01519-9. Epub 2023 Jun 12.
Autoimmune Hepatitis (AIH) is an immune-mediated liver disease of unknown origin. Its clinical presentation is heterogeneous and ranges from asymptomatic courses over several years to acute forms with acute liver failure. Accordingly, the diagnosis is only made at the stage of cirrhosis in about one third of affected individuals. Early diagnosis and a consistent, adequate, individualized, immunosuppressive therapy are crucial for the prognosis, which is excellent when treated properly. AIH is rare in the general population and can be easily overlooked due to its variable clinical picture and sometimes difficult diagnosis. AIH should be considered as a differential diagnosis in any unclear acute or chronic hepatopathy. The therapy initially consists of remission induction and subsequently maintenance therapy with (often lifelong) immunosuppressants.
自身免疫性肝炎(AIH)是一种病因不明的免疫介导性肝病。其临床表现具有异质性,从数年无症状病程到伴有急性肝衰竭的急性形式不等。因此,约三分之一的受影响个体在肝硬化阶段才得以确诊。早期诊断以及持续、充分、个体化的免疫抑制治疗对预后至关重要,若治疗得当,预后良好。AIH在普通人群中较为罕见,因其临床表现多样且有时诊断困难,很容易被忽视。在任何不明原因的急性或慢性肝病中,都应将AIH视为鉴别诊断之一。治疗最初包括诱导缓解,随后使用(通常是终身的)免疫抑制剂进行维持治疗。