Heintges T, Mohr L, Niederau C, Strohmeyer G
Klinik für Gastroenterologie, Hepatologie und Infektiologie, Heinrich-Heine-Universität Düsseldorf.
Z Gastroenterol. 1995 Aug;33(8):462-7.
Thorough differential diagnosis in patients with autoimmune hepatitis is important since other liver disorders need different treatment regimen. Elevated transaminases and gamma-globulines and autoantibodies should make one think of autoimmune hepatitis. Liver biopsy is helpful but usually not a definitive proof of the diagnosis. Immunosuppressive therapy has to be administered for years and possibly leads to serious side effects. Therapy should only be discontinued if a complete remission is induced. Relapses after cessation of medical treatment occur frequently. If no remission is achieved lifelong immunosuppressive therapy has to be given. In decompensated disease liver transplantation offers a treatment with good prognosis.
对自身免疫性肝炎患者进行全面的鉴别诊断很重要，因为其他肝脏疾病需要不同的治疗方案。转氨酶、γ-球蛋白和自身抗体升高应使人想到自身免疫性肝炎。肝活检有帮助，但通常不是诊断的确切依据。免疫抑制治疗必须持续数年，且可能导致严重的副作用。只有在诱导完全缓解后才能停止治疗。停药后复发很常见。如果未实现缓解，则必须进行终身免疫抑制治疗。在失代偿性疾病中，肝移植提供了一种预后良好的治疗方法。
