Autoimmune hepatitis history and symptoms
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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
Patient with autoimmune hepatitis presents asymptomatic or with symptoms of acute liver failure. A positive history of viral infections like hepatitis A, C, and drug intake like minocycline, interferon α, nitrofurantoin, infliximab, ezetimibe, interferon β, ornidazole, diclofenac, indomethacin, terbinafine, methyldopa, ranitidine, atorvastatin, fluvastatin, fibrates, adalimumab is suggestive of autoimmune hepatitis. The common symptoms of autoimmune hepatitis include jaundice, fatigue, and abdominal discomfort. Less common symptoms of autoimmune hepatitis include acne, edema, hirsutism, amenorrhea.
History
- The majority of patients with autoimmune hepatitis are initially asymptomatic but leads to severe symptoms and progresses even to fulminant hepatitis.
- Autoimmune hepatitis can present as acute hepatitis, chronic hepatitis, or well-established cirrhosis. Autoimmune hepatitis can rarely present as the fulminant hepatic failure.
- The hallmark of autoimmune hepatitis is fatigue and jaundice.
Past Medical History
- History of hepatitis A, hepatitis E, cytomegalovirus, and Epstein–Barr virus.
- History of hepatitis A vaccination.[1][2][3][4][5]
Medication History
- Prior use of minocycline, interferon α, nitrofurantoin, infliximab, ezetimibe, interferon β, ornidazole, diclofenac, indomethacin, terbinafine, methyldopa, ranitidine, atorvastatin, fluvastatin, fibrates, adalimumab increases the risk of autoimmune hepatitis.[6][7][8][9][10]
Common Symptoms
Common symptoms of autoimmune hepatitis include:[11][12][13][14][15]
- Fatigue
- Lethargy
- Abdominal discomfort
- Mild pruritus
- Anorexia
- Myalgia
- Diarrhea
- Arthralgias involving small joints
- Dark urine
- Pale or gray-colored stools
- Skin rashes
- Weight loss
Less Common Symptoms
Less common symptoms of autoimmune hepatitis include:
References
- ↑ Nagasaki F, Ueno Y, Mano Y, Igarashi T, Yahagi K, Niitsuma H, Okamoto H, Shimosegawa T (2005). "A patient with clinical features of acute hepatitis E viral infection and autoimmune hepatitis". Tohoku J. Exp. Med. 206 (2): 173–9. PMID 15888974.
- ↑ Castellote J, Güell E, Porta F (2001). "[Autoimmune hepatitis following cytomegalovirus infection]". Med Clin (Barc) (in Spanish; Castilian). 117 (2): 76. PMID 11446931.
- ↑ Kamisako T, Tsubaki K, Adachi Y, Kamisato T (1997). "Autoimmune hepatitis after cytomegalovirus infection in a bone marrow-transplanted patient". Am. J. Gastroenterol. 92 (7): 1238–9. PMID 9219819.
- ↑ Huppertz HI, Treichel U, Gassel AM, Jeschke R, Meyer zum Büschenfelde KH (1995). "Autoimmune hepatitis following hepatitis A virus infection". J. Hepatol. 23 (2): 204–8. PMID 7499793.
- ↑ Vento S, Cainelli F (2004). "Is there a role for viruses in triggering autoimmune hepatitis?". Autoimmun Rev. 3 (1): 61–9. doi:10.1016/S1568-9972(03)00053-3. PMID 14871651.
- ↑ 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.
- ↑ Colmegna I, Perandones CE, Chaves JG (2000). "Minocycline induced lupus and autoimmune hepatitis". J. Rheumatol. 27 (6): 1567–8. PMID 10852297.
- ↑ Heathcote EJ (1995). "Autoimmune hepatitis and chronic hepatitis C: latent or initiated by interferon therapy?". Gastroenterology. 108 (6): 1942–4. PMID 7539390.
- ↑ Germano V, Picchianti Diamanti A, Baccano G, Natale E, Onetti Muda A, Priori R, Valesini G (2005). "Autoimmune hepatitis associated with infliximab in a patient with psoriatic arthritis". Ann. Rheum. Dis. 64 (10): 1519–20. doi:10.1136/ard.2004.032821. PMC 1755231. PMID 16162908.
- ↑ Goldstein NS, Bayati N, Silverman AL, Gordon SC (2000). "Minocycline as a cause of drug-induced autoimmune hepatitis. Report of four cases and comparison with autoimmune hepatitis". Am. J. Clin. Pathol. 114 (4): 591–8. doi:10.1309/KV2J-VX6Q-L95V-VDE4. PMID 11026106.
- ↑ Makol A, Watt KD, Chowdhary VR (2011). "Autoimmune hepatitis: a review of current diagnosis and treatment". Hepat Res Treat. 2011: 390916. doi:10.1155/2011/390916. PMC 3132488. PMID 21760995.
- ↑ Kim BH, Kim YJ, Jeong SH, Tak WY, Ahn SH, Lee YJ, Jung EU, Lee JI, Yeon JE, Hwang JS, Um SH, Seo YS, Kim YS, Song BC, Kim JH, Jung YK, Park CK, Kim KA, Min HJ, Cho EY, Lee ES, Kwon SY, Chae HB, Kim DJ, Shin SR (2013). "Clinical features of autoimmune hepatitis and comparison of two diagnostic criteria in Korea: a nationwide, multicenter study". J. Gastroenterol. Hepatol. 28 (1): 128–34. doi:10.1111/j.1440-1746.2012.07292.x. PMID 23033899.
- ↑ Miyake Y, Iwasaki Y, Takaki A, Kobashi H, Sakaguchi K, Shiratori Y (2007). "Clinical features of Japanese elderly patients with type 1 autoimmune hepatitis". Intern. Med. 46 (24): 1945–9. PMID 18084114.
- ↑ Bellomo-Brandão MA, Costa-Pinto EA, De Tommaso AM, Hessel G (2006). "Clinical and biochemical features of autoimmune hepatitis in 36 pediatric patients". Arq Gastroenterol. 43 (1): 45–9. doi:/S0004-28032006000100012 Check
|doi=value (help). PMID 16699618. - ↑ Yasui S, Fujiwara K, Yonemitsu Y, Oda S, Nakano M, Yokosuka O (2011). "Clinicopathological features of severe and fulminant forms of autoimmune hepatitis". J. Gastroenterol. 46 (3): 378–90. doi:10.1007/s00535-010-0316-3. PMID 20821236.