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Pathology - Autoimmune hepatitis
Definition: A hepatic disorder resulting from an autoimmune reaction directed at the liver.
Epidemiology: Rare occurrence. • Generally impacts middle-aged women. Aetiology • Definitively unknown, yet believed to be precipitated by infection or pharmacological agents.
Pathogenesis • Contemporary understanding posits that liver injury resulting from an infection or pharmacological agent leads genetically predisposed individuals to develop sensitization to their liver, subsequently eliciting an immune response against it.
Presentation • The majority of cases are asymptomatic during the initial stages, although may be identified accidentally through irregularities in liver function testing. • Certain patients exhibit delayed presentation with manifestations of chronic liver disease or end-stage cirrhosis. Approximately 25% of cases manifest abruptly with an episode of severe hepatitis accompanied by jaundice. Occasionally, significant acute liver injury manifests, resulting in abrupt hepatic failure in the patient.
Serology • Serum IgG levels are typically elevated. • Various autoantibodies may be detected, including anti-nuclear antibodies, liver-kidney microsomal antibodies, and smooth muscle antibodies.
Macroscopy • Limited macroscopic alterations, observed mostly in patients with cirrhosis or in instances of severe acute hepatitis characterized by extensive hepatocyte necrosis.
Histopathology • Chronic hepatitis exhibits a pattern of injury characterized by portal inflammation, interface hepatitis, lobular inflammation, and variable fibrosis. • Unlike chronic viral hepatitis, interface hepatitis and lobular inflammation are typically more pronounced. Plasma cells are frequently a prominent element of the inflammatory cell infiltrate.
Prognosis • The majority of cases exhibit favorable responses to immunosuppressive therapy. • The long-term prognosis is contingent upon the degree of fibrosis present in the liver at the time of diagnosis.
Definition: A hepatic disorder resulting from an autoimmune reaction directed at the liver.
Epidemiology: Rare occurrence. • Generally impacts middle-aged women. Aetiology • Definitively unknown, yet believed to be precipitated by infection or pharmacological agents.
Pathogenesis • Contemporary understanding posits that liver injury resulting from an infection or pharmacological agent leads genetically predisposed individuals to develop sensitization to their liver, subsequently eliciting an immune response against it.
Presentation • The majority of cases are asymptomatic during the initial stages, although may be identified accidentally through irregularities in liver function testing. • Certain patients exhibit delayed presentation with manifestations of chronic liver disease or end-stage cirrhosis. Approximately 25% of cases manifest abruptly with an episode of severe hepatitis accompanied by jaundice. Occasionally, significant acute liver injury manifests, resulting in abrupt hepatic failure in the patient.
Serology • Serum IgG levels are typically elevated. • Various autoantibodies may be detected, including anti-nuclear antibodies, liver-kidney microsomal antibodies, and smooth muscle antibodies.
Macroscopy • Limited macroscopic alterations, observed mostly in patients with cirrhosis or in instances of severe acute hepatitis characterized by extensive hepatocyte necrosis.
Histopathology • Chronic hepatitis exhibits a pattern of injury characterized by portal inflammation, interface hepatitis, lobular inflammation, and variable fibrosis. • Unlike chronic viral hepatitis, interface hepatitis and lobular inflammation are typically more pronounced. Plasma cells are frequently a prominent element of the inflammatory cell infiltrate.
Prognosis • The majority of cases exhibit favorable responses to immunosuppressive therapy. • The long-term prognosis is contingent upon the degree of fibrosis present in the liver at the time of diagnosis.
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