Clinicopathological features of severe and fulminant forms of autoimmune hepatitis

Abstract

We should diagnose and treat acute onset AIH patients before they develop into severe and fulminant disease. Performing liver biopsy at the early stage of acute onset AIH, evaluating the biopsy specimens precisely and initiating corticosteroid therapy may be essential for improving the prognosis without liver transplantation.

Clinicopathological profile and management of severe autoimmune hepatitis

“…14 Biochemical improvement after two weeks of steroid therapy assured immediate survival in a cohort of SAH and non-improving bilirubinemiaby two weeks along with multilobular liver necrosis predicted mortality. 10 Lack of early serum bilirubin reduction by day 7 was synonymous with unsuccessful response to steroids, consistent with other studies. 3,14,15 This should be a warning signaling unabated liver cell necrosis and lack of control of inflammation by steroid therapy.…”

Role of Histopathology in Autoimmune Hepatitis

“…Liver biopsy may exclude other aetiology and support the diagnosis of AIH by identifying centrilobular necrosis, with or without interface hepatitis, and other typical features of AIH [23,25] . Early liver biopsy is proposed by many investigators for the diagnosis of acute-onset AIH [26] . Histological features of established fibrosis serve as evidence of chronicity in acute-onset AIH.…”

Autoimmunhepatitis – Klinik, Diagnostik, Therapie

“…IgG-Spiegel finden sich in etwa 85 % der Patienten mit AIH [19], wobei von niedrigeren Präva-lenzen bei Patienten mit akuten Verlaufsformen berichtet wurde. So finden sich bei 25-39 % dieser Patientengruppe normale IgG-Spiegel [20].…”