Diagnosis and Management of Autoimmune Hepatitis

被引：61

作者：

Czaja, Albert J. ^{[1
]}

机构：

[1] Mayo Clin, Div Gastroenterol & Hepatol, Coll Med, Rochester, MN 55905 USA

来源：

CLINICS IN LIVER DISEASE | 2015年 / 19卷 / 01期

关键词：

Autoimmune; Hepatitis; Diagnosis; Steroids; Suboptimal responses; Salvage therapies; CHRONIC ACTIVE HEPATITIS; LIVER ANTIGEN/LIVER PANCREAS; INFLAMMATORY-BOWEL-DISEASE; BILE-DUCT INJURY; CORTICOSTEROID-THERAPY; SCLEROSING CHOLANGITIS; CLINICAL-FEATURES; INITIAL PRESENTATION; HISTOLOGIC FEATURES; SUSTAINED REMISSION;

D O I：

10.1016/j.cld.2014.09.004

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

100201 [内科学];

摘要：

Autoimmune hepatitis is characterized by increased serum aminotransferase levels, autoantibodies, hypergammaglobulinemia, and interface hepatitis. Presentation can be acute, severe (fulminant), asymptomatic, or chronic. Diagnosis requires multiple findings and exclusion of similar diseases. Treatment with prednisone or prednisolone with azathioprine is recommended. Budesonide with azathioprine has normalized laboratory test with few side effects, but histologic resolution, durability of response, and target population are uncertain. Progressive worsening, incomplete improvement, drug intolerance, and relapse after drug withdrawal are suboptimal outcomes. Calcineurin inhibitors and mycophenolate mofetil are salvage agents in small series and liver transplantation is effective for liver failure.

引用

页码：57 / 79

页数：23

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