Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 29 May 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Current management of autoimmune hepatitis

October's issue of the Alimentary Pharmacology & Therapeutics reviews current management and challenges of autoimmune hepatitis.

News image

Autoimmune hepatitis is a disease of unknown etiology characterized by interface hepatitis, hypergammaglobulinemia, circulating autoantibodies and a favorable response to immunosuppression.

Professor Dalekos and colleagues from Greece reviewed recent advancements in understanding aetiopathogenesis, clinical, serological and histological features, diagnostic criteria and treatment strategies of autoimmune hepatitis.

Published studies on autoimmune hepatitis extracted mainly from PubMed during the last 15 years.

Autoimmune hepatitis has a global distribution affecting any age, both sexes and all ethnic groups.

Liver histology and autoantibodies still remain the hallmark for diagnosis
Alimentary Pharmacology & Therapeutics

The team report that clinical manifestations are variable ranging from no symptoms to severe acute hepatitis and only seldom to fulminant hepatic failure.

Autoimmune attack is perpetuated, possibly via molecular mimicry mechanisms, and favored by the impaired control of regulatory T-cells.

A typical laboratory finding is hypergammaglobulinemia with selective elevation of IgG, although in 15–25% of patients – particularly children, elderly and acute cases – IgG levels are normal.

The research team found that liver histology and autoantibodies, although not pathognomonic, still remain the hallmark for diagnosis.

The researchers report that immunosuppressive treatment is mandatory and life-saving.

However, to meet strict response criteria, the conventional therapy with prednisolone with or without azathioprine is far from ideal.

Professor Dalekos' team concludes, "Autoimmune hepatitis remains a major diagnostic and therapeutic challenge."

"The clinician, the hepato-pathologist and the laboratory personnel need to become more familiar with different expressions of the disease, interpretation of liver histology and autoimmune serology."

"According to the strict definition of treatment response issued by the 2010 AASLD guidelines, many patients are nonresponders to conventional treatment."

"Newer immunosuppressive agents targeting pathogenetic mechanisms can improve patient management, which needs to be tailored on a case-by-case basis."

Aliment Pharmacol Ther 2013: 38(8): 887–913
30 September 2013

Go to top of page Email this page Email this page to a colleague

 27 May 2016 
Obstructive sleep apnea and NASH
 27 May 2016 
Risk stratification in acute upper GI bleeding
 27 May 2016 
Hepatocellular carcinoma in chronic Hep B patients
 26 May 2016 
Education booklet for colonoscopy bowel preparation
 26 May 2016 
Uncomplicated diverticulitis in outpatients
 26 May 2016 
Direct-acting antivirals in Hep C cirrhosis
 25 May 2016 
Preventing NSAID-associated GI toxicity
 25 May 2016 
Recurrence of Barrett’s after successful endoscopic therapy
 25 May 2016 
PPIs and NSAID-induced small bowel injury
 24 May 2016 
Fecal inflammatory markers in Crohn's
 24 May 2016 
Depression and IBD recurrence
 24 May 2016 
New therapies for NASH
 23 May 2016 
Risk factors for peptic ulcer bleeding outcomes
 23 May 2016 
Liver transplantation for hepatocellular carcinoma
 23 May 2016 
Cancer after colectomy in IBD
 20 May 2016 
Biomarker for colorectal cancer diagnosis
 20 May 2016 
Prognostic score for hepatic venous outflow obstruction
 20 May 2016 
Treatment for uncomplicated acute diverticulitis
 19 May 2016 
Probiotics and H. pylori eradication
 19 May 2016 
Impaired skeletal health in atrophic gastritis
 19 May 2016 
Predicting outcome in ulcerative colitis
 18 May 2016 
Erectile dysfunction in IBD
 18 May 2016 
Acute GERD and esophageal histologic changes
 18 May 2016 
Surgical fundoplication for GERD 
 17 May 2016 
Mucosal dysbiosis in Crohn's disease
 17 May 2016 
Vitamin D level and clinical status in IBD 
 17 May 2016 
Inpatient costs for IBD and acute pancreatitis
 16 May 2016 
Outcomes of postcolonoscopy colorectal cancers
 16 May 2016 
Therapy for Crohn's in a Medicaid population
 16 May 2016 
C. difficile in ulcerative colitis patients
 13 May 2016 
Parkinson's disease and IBD
 13 May 2016 
Inactivated oral cholera vaccine
 13 May 2016 
Non-traditional heart disease risk factors in NAFLD
 12 May 2016 
Gestational diabetes mellitus and NAFLD
 12 May 2016 
Impact of Crohn's in the USA
 12 May 2016 
Ozanimod induction and ulcerative colitis
 11 May 2016 
Anti-TNF discontinuation in IBD
 11 May 2016 
Prognosis after colorectal cancer resection
 11 May 2016 
Age and disease presentation with Crohn's disease
 10 May 2016 
Noninvasive test for IBD
 10 May 2016 
Gluten-free diet in patients with IBS-diarrhea
 10 May 2016 
Digital health for gastroenterology
 09 May 2016 
Diarrheal infections in adults
 09 May 2016 
Quality improvement initiative and readmission for cirrhosis
 09 May 2016 
Coffee or tea and the risk of Barrett's
 06 May 2016 
Risk factors in peptic ulcer bleeding
 06 May 2016 
Recurrent pancreatitis after acute pancreatitis
 06 May 2016 
Managing acute lower GI bleeding
 05 May 2016 
Chemoradiotherapy vs chemotherapy for pancreatic cancer
 05 May 2016 
Genetics in early-early-onset IBD
 05 May 2016 
Reductions in quality of screening colonoscopies
 04 May 2016 
Anti-TNF therapy for IBD
 04 May 2016 
Bismuth and H. pylori eradication
 04 May 2016 
Chromoendoscopy vs colonoscopy for dysplasia in colitis
 03 May 2016 
Vedolizumab for IBD
 03 May 2016 
Surgery vs medical therapy for GERD
 03 May 2016 
PPIs and gut microbiota
 02 May 2016 
Genetic variant that increase NAFLD risk
 02 May 2016 
Resection of colorectal polyps
 02 May 2016 
Mycophenolate mofetil as first-line treatment of autoimmune hepatitis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us