High level of persistent liver injury is one of clinical characteristics in treatment‐naïve acute onset autoimmune hepatitis: experience in a community hospital

Abstract

Long persistence of high levels of alanine aminotransferase would be one of clinical features for considering A-AIH along with conventional features. Histological diagnostic features should be applied for such patients. Guidelines for diagnosing A-AIH should be urgently drawn up.

Acute presentation of autoimmune hepatitis: a multicentre study with detailed histological evaluation in a large cohort of patients

“…The present data revealed various histological patterns of AIH with acute presentations reported in earlier studies, in which histological features of acute hepatitis, including CN, submassive necrosis and massive necrosis, were present in 12.2–88% cases 6 7 20 24 28 29 34–39. However, as mentioned, individual histological features were less specified and their proportions were widely different among previous reports 5–7 16 24 27–29 35 36 38 42…”

Diagnostic utility of radiological heterogeneity in acute severe (fulminant) autoimmune hepatitis

“…There are no pathognomonic findings of AIH, therefore, histological feature is one of parameters for diagnosing AIH, and it should be applied, along with other parameters, only to patients whom experienced hepatologists consider to be AIH clinically, for avoiding overdiagnosis and misdiagnosis. For considering AIH, we proposed that persistence of high levels of alanine aminotransferase in acute‐onset AIH and presence of heterogeneous hypoattenuation on unenhanced CT in acute severe (fulminant) AIH would be helpful along with conventional features.…”

Acute Exacerbation to Autoimmune Hepatitis Mimicking Acute Viral Hepatitis—A Case Series and Review of Literature

“…In our study the autoantibodies were undetectable in 44%, this is similar to other studies from Italy, The United States and Japan where 27%, 31% and 29% patients were negative for ANA, 18%, 15% and 68% patients were negative for ASMA respectively. [17][18][19][20] Liver biopsy and histopathological examination are warranted in all patients with AIH because of frequent deviations from the classical phenotype. Approximately 18-55% have shown evidence of acute exacerbation of AIH in previous studies.…”

“…Hepatocyte loss, n (%) 6 (50) Emperipolesis, n (%) 3 (25) Ductopenia, n (%) 2 (17) Bile duct inflammation, n (%) 2 (17) Intrahepatocytic cholestasis, n (%) 8 (67)…”