Hepatitis autoinmune

Abstract

Autoimmune hepatitis (AIH) is a hepatocellular inflammation that is characterised by a wide range of histopathologic (periportal interface hepatitis with plasma cell infiltration and piecemeal necrosis), biochemical (hypertransaminasemia, hypergammaglobulinaemia) and autoimmune (several autoantibodies presence) features. This relatively rare disorder frequently affects middle-aged women. There is no pathognomonic marker for AIH diagnosis, therefore it requires a careful rule out of other causes of liver disease together with the detection of a suggestive pattern of clinical and laboratory abnormalities. Scoring system for AIH diagnosis proposed by International Autoimmune Hepatitis Group has been used as a tool in clinical practice but is not sufficiently exclusive in terms of defining prognosis or treatment. AIH has been classified in two subtypes according to autoantibodies detected: 1 and 2, but this classification results in poor clinical implications. Previously known as subtype 3 is at the present included in subtype 1 because no clinical significant differences has been found between them. Aetiology, and molecular mechanisms still remain to be elucitaded in this disease, although viruses, drugs and molecular mimicry act presumably as a trigger in genetically predisposed patients (associated with HLA-DR3 and DR4 haplotypes). On the other hand, immunosuppressive therapy (corticosteroid or azathioprine) generally offers favourable response. Our aim is to review this disease from different points of view, considering: clinical, histopathological, etiologic, genetic, biochemical, autoimmune, treatment and prognosis features.

Hígado Graso no Alcohólico en mujeres

“…En las mujeres, los factores de riesgo para desarrollar Enfermedad Hepática por Hígado Graso no Alcohólico (EHGNA) incluyen el estado menopáusico, donde la disminución del gasto de energía y el aumento de adiposidad visceral promueven la EHGNA independientemente del envejecimiento cronológico (Brin et al, 2019). La hemocromatosis hereditaria, caracterizada por la acumulación excesiva de hierro en órganos como el hígado, y la autoinmune, una condición en la que el sistema inmunológico ataca a los hepatocitos, también se asocian con un mayor riesgo de EHGNA en mujeres (Orts Costa et al, 2004). Estos factores de riesgo deben ser considerados para prevenir, diagnosticar y tratar adecuadamente esta enfermedad, reduciendo así las complicaciones hepáticas asociadas.…”