Autoimmune liver disease following acute hepatitis A infection

Yeend-Curd-Trimble, Hannah; Kelly, Kate; Ghosh, Indrajit; MacDonald, Douglas

doi:10.1136/bcr-2018-228433

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…Certain viruses (hepatitis A, B, C and measles) have been implicated in the pathogenesis of AIH and are believed to trigger ongoing immune-mediated hepatic inflammation, even after resolution of infection. [26][27][28][29][30][31][32][33][34] In a single-centre study (n = 52) investigating the potential triggers of AIH-ALF, a trigger was found in 50% of cases. 35 These were predominantly drug-related (58%), however, a viral cause was found in 31% of cases.…”

Section: Aetiologymentioning

confidence: 99%

Approach to the patient with acute severe autoimmune hepatitis

2020

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Autoimmune hepatitis is associated with varied clinical presentations and natural history, as well as somewhat unpredictable treatment responses. Understanding how to stratify patients who require further escalation of therapy will help clinicians manage these patients. The presentation of acute severe autoimmune hepatitis (AS-AIH) is relatively uncommon, although its prevalence is potentially greater than currently perceived. Previous studies consist of small retrospective single-centre series and are not directly comparable due to the diversity of presentations, disease definitions and non-standardised treatment regimens. We define AS-AIH as those who present acutely with AIH and are icteric with an international normalised ratio > − 1.5 and no evidence of hepatic encephalopathy. Those with hepatic encephalopathy should be defined as having AS-AIH with acute liver failure. In this review, we provide a structured practical approach for diagnosing and managing this unique group of patients.

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