Autoimmune hepatitis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: :Manpreet Kaur, MD [2]

Overview

Autoimmune hepatitis has a bimodal age distribution, with the first peak of incidence at age 10-20 years and a second at age 45-70 years. Patients presents initially with no symptom but can progress to acute liver failure If not treated, patients can develop complications like cirrhosis, portal hypertension, esophageal varices, metabolic bone disease, hyperlipidaemia, hypovitaminosis, cholestasis. Prognosis is generally excellent, and the 10-year survival rate of patients with autoimmune hepatitis treated with immunosuppressive therapy is approximately 80%. The presence of young age at presentation, AIH-2, coagulopathy, severe histologic activity is associated with a poor prognosis among patients with autoimmune hepatitis.

Natural History

Complications

Common complications of Autoimmune hepatitis include:[2][3]

Prognosis

References

  1. Sonthalia N, Rathi PM, Jain SS, Surude RG, Mohite AR, Pawar SV, Contractor Q (2017). "Natural History and Treatment Outcomes of Severe Autoimmune Hepatitis". J. Clin. Gastroenterol. 51 (6): 548–556. doi:10.1097/MCG.0000000000000805. PMID 28272079.
  2. Trivedi PJ, Hirschfield GM (2013). "Treatment of autoimmune liver disease: current and future therapeutic options". Ther Adv Chronic Dis. 4 (3): 119–41. doi:10.1177/2040622313478646. PMC 3629750. PMID 23634279.
  3. Gleeson D, Heneghan MA (2011). "British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis". Gut. 60 (12): 1611–29. doi:10.1136/gut.2010.235259. PMID 21757447.
  4. Hoeroldt B, McFarlane E, Dube A, Basumani P, Karajeh M, Campbell MJ, Gleeson D (2011). "Long-term outcomes of patients with autoimmune hepatitis managed at a nontransplant center". Gastroenterology. 140 (7): 1980–9. doi:10.1053/j.gastro.2011.02.065. PMID 21396370.
  5. D'Amico G, Garcia-Tsao G, Pagliaro L (2006). "Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies". J. Hepatol. 44 (1): 217–31. doi:10.1016/j.jhep.2005.10.013. PMID 16298014.

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