Autoimmune hepatitis

📍What causes Autoimmune Hepatitis?

💡 Autoimmune hepatitis (AIH) is a chronic inflammatory process in the liver of unknown origin, characterized by periportal inflammation, the presence of hypergammaglobulinemia, and tissue autoantibodies.

🔬 Diagnosis of autoimmune hepatitis.
In the diagnosis of autoimmune hepatitis, the determination of such markers as: antinuclear antibodies (ANA), antibodies to liver and kidney microsomes (anti-LKM), and antibodies to smooth muscle (SMA) is of great importance.

🔬 To establish a definite diagnosis, it is necessary: no history of blood transfusions, taking hepatotoxic drugs, alcohol abuse; no serum markers of active viral infection and ANA, AMA titers; significant increase in the activity of AST, ALT and less pronounced increase in alkaline phosphatase.

🔬 Histological examination of AIG in liver tissue usually reveals a picture of chronic hepatitis with pronounced activity. Typical bridge-like parenchymal necrosis, a large number of plasma cells in the inflammatory infiltrate in the portal tracts and areas of hepatocyte necrosis. Lymphocytes of the infiltrate often form lymphoid follicles in the portal tracts, and periportal hepatocytes create the so-called glandular (glandular) structures. Massive lymphoid infiltration is noted in the centers of the lobules with large hepatocyte necrosis.

Inflammation of the small bile ducts and portal tract cholangiolar tracts is common, while the interlobular and septal ducts are intact. Hepatocyte changes are manifested by hydropic or fatty degeneration.

Sometimes, as a separate cross-syndrome, the combination of AIH with autoimmune cholangitis is also distinguished, which proceeds similarly to AIH syndrome, but in the absence of serum AMA.