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:
Overview
The majority of patients with [disease name] are asymptomatic.
OR
The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History and Symptoms
- The majority of patients with Autoimmune hepatitis are asymptomatic leads to severe symptoms and progresses even to fulminant hepatitis
- The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
- Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History
Patients with [disease name]] may have a positive history of:
- [History finding 1]
- [History finding 2]
- [History finding 3]
Common Symptoms
Common symptoms of Autoimmune hepatitis include:[1][2][3][4]
- Fatigue
- Lethargy
- Upper 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 :
- Edema
- Acne
- Hirsutism
- Amenorrhea
- Chest pain from pleuritis
- Extrahepatic manifestations are generally due to the company that AH keeps:
- Chronic autoimmune thyroiditis
- Hyperthyroidism (Graves’ disease)
- Ulcerative colitis
- Hemolytic anemia
- Idiopathic thrombocytopenia
- Diabetes mellitus
- Diabetes insipidus
- Celiac disease
- Polymyositis
- Myasthenia gravis
- Pulmonary fibrosis
- Pericarditis
- Glomerulonephritis
- Acute lichenoid pityriasis
- Febrile panniculitis
- Hypereosinophilic syndrome
- Sjogren’s syndrome
- Mixed connective tissue disease
- Although PSC is generally thought to be the liver disease most commonly associated with uterine contractions (UC), AH and UC often coexist, with the liver disease predating the colonic disease.
- AH is also associated with hepatocellular carcinoma, though many patients who eventually develop hepatocellular carcinoma have also been found to have hepatitis C.
- The LFT abnormalities are generally that of a marked transaminitis with a milder increase in Total bilirubin, alkalen phosphatase and PT.
- Some patients, however, have more of a cholestatic picture.
- Unfortunately, the symptoms and degree of enzyme abnormalities do not necessarily correlate with the pathology.
- As above, however, most patients have at least some degree of cirrhosis at the time of initial biopsy.
- Hyperglobulinemia (usually gamma-globulin) is a characteristic feature of AH, though is not present in 100% of cases.
- Anti-actin antibodies are generally not tested for in most labs, despite the fact that they are more specific than the other tests for AH.
- An anti-smooth muscle Ab titer > 1:320, however, is generally thought to reflect the presence of anti-actin antibodies.
- In the spectrum of autoimmune disease ranging from organ-specific to non-organ-specific, AH falls somewhere in the middle, as the disease is often confined to the liver, but the antibodies are mostly nonspecific.
- A scoring system has been developed by the International Autoimmune Hepatitis Group in order to facilitate the diagnosis.
References
- ↑ 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.