Autoimmune hepatitis (AIH) is a chronic inflammatory disease in which the immune system attacks the liver. Three findings define it: circulating autoantibodies, a raised serum immunoglobulin G (hypergammaglobulinaemia), and interface hepatitis on liver biopsy — inflammation at the boundary between the portal tract and the liver lobule, where hepatocytes meet the portal connective tissue. No single finding is specific to AIH, and some patients lack one or more of them, so the diagnosis is built from the combination together with the exclusion of the chronic liver diseases that look the same.
Choose a route through the topic
Start with the mechanism.
- Pathophysiology of Autoimmune Hepatitis: how tolerance to hepatocyte self-antigens is lost, how CD8+ T cells and the cells around them destroy hepatocytes, and how that injury becomes fibrosis.
- Epidemiology of Autoimmune Hepatitis: how common AIH is, how that varies between regions, and which groups it affects.
Then the features that bring it to notice.
- Clinical Manifestations of Autoimmune Hepatitis: the symptoms, physical findings and laboratory changes, from fatigue and hepatomegaly to the selective rise in IgG.
- Clinical Patterns of Autoimmune Hepatitis: the ways it can present, from asymptomatic disease through acute severe and fulminant hepatitis to the overlap syndromes.
Then the serological and histological features that define the diagnosis.
- Autoantibodies in Autoimmune Hepatitis: the conventional and less common antibodies, what each marks, and what a positive result does and does not prove.
- Serological Types of Autoimmune Hepatitis: the type 1 and type 2 classification, the patients each describes, and why the distinction changes follow-up.
- Liver Histology in Autoimmune Hepatitis: the biopsy features, from interface hepatitis to plasma cells, rosettes and emperipolesis.
Finally, putting the pieces together.
- Diagnosis and Treatment of Autoimmune Hepatitis: the diagnostic criteria and the diseases that must be excluded, the scoring systems, and the treatment and its endpoints.