Autoimmune Hepatitis

 

Epidemiology:

    • Female predominance (78%)
      • Particularly young and perimenopausal women
    • White Northern Europeans highest incidence

 

Common sites:

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Gross features:

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Histologic features:

    • prominent inflammatory infiltrates of lymphocytes and plasma cells
      • prominent plasma cells in infiltrate is a clue
      • parenchymal inflammation is more prominent than in viral hepatitis – it is harder to find portal tracts
    • destruction of bile ducts in a small subset

 

Immunophenotype:

Marker:

Sensitivity:

Specificity:

 

 

 

 

Molecular features:

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Other features:

    • elevated IgG and gamma-globulin
    • high serum titers of autoantibodies (80%)
      • ANA, anti-smooth muscle (SMA), antiliver/kidney microsomes (anti-LKM1) antibodies
    • Negative antimitochondrial antibody (AMA)
    • Negative viral serologic markers
    • Associated with other autoimmune diseases (60%)
      • RA, thyroiditis, Sjogren, UC

 

References:

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