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Frontline Gastroenterol. 2019 Jan;10(1):77-87. doi: 10.1136/flgastro-2018-101015. Epub 2018 Aug 12.

Autoimmune hepatitis and complexities in management.

Author information

1
Centre for Liver Research, NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK.
2
University Hospitals Birmingham NHS Foundation Trust Birmingham UK, Birmingham, UK.
3
Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK.
4
Toronto Centre for Liver Disease, University Health Network, University of Toronto, Toronto, Canada.

Abstract

Autoimmune hepatitis (AIH) is a rare heterogenous immune-mediated liver disease that for the majority has effective therapy, usually resulting in excellent prognosis. Treatment is based on immunosuppression using standard therapy with corticosteroids and azathioprine. Second-line therapeutic options exist for those who are non-responders ('difficult to treat AIH') or intolerant to standard therapy; however, their use is not standardised, and in addition, there is vast variation in practice and efficacy. Given the rarity of AIH, expertise in its management can be limited to large referral programmes. In this case-based review, we aim to discuss common clinical dilemmas encountered by clinicians managing adult patients with AIH and address the related competencies in the 2010 Gastroenterology curriculum.

KEYWORDS:

autoimmune hepatitis; autoimmune liver disease; immune-mediated liver damage; immunotherapy; liver transplantation

Comment in

PMID:
30651962
PMCID:
PMC6319158
[Available on 2020-01-01]
DOI:
10.1136/flgastro-2018-101015

Conflict of interest statement

Competing interests: GMH has received speaker fees from Falk Pharma.

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