Autoimmune Hepatitis: From Evolution to Current Status—A Pathologist’s Perspective
Autoimmune hepatitis (AIH) is a chronic, relapsing and remitting, immune-mediated liver disease that progresses to cirrhosis if left untreated. A significant number of patients may present with acute hepatitis or acute liver failure, which are often misdiagnosed as toxic liver injury. AIH shows a pr...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/14/2/210 |
| _version_ | 1797344300467486720 |
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| author | Puja Sakhuja Surbhi Goyal |
| author_facet | Puja Sakhuja Surbhi Goyal |
| author_sort | Puja Sakhuja |
| collection | DOAJ |
| description | Autoimmune hepatitis (AIH) is a chronic, relapsing and remitting, immune-mediated liver disease that progresses to cirrhosis if left untreated. A significant number of patients may present with acute hepatitis or acute liver failure, which are often misdiagnosed as toxic liver injury. AIH shows a preponderance in young women but may be seen in children and the elderly. Diagnosis requires the integration of clinical, biochemical, and serologic parameters, along with supportive liver histology and exclusion of other causes of liver disease. Liver biopsy is a prerequisite for diagnosis of AIH, to assess severity and stage of disease, exclude other entities, and recognize any concurrent morbidities. No single biomarker or histologic feature is pathognomonic for AIH. The diagnostic and histologic criteria have undergone several modifications since the original scoring system was proposed by the International Autoimmune Hepatitis Group (IAIHG) in 1993. Recently, the IAIHG has proposed consensus recommendations for histologic criteria, relevant for both acute and chronic AIH. This review article will describe the evolving diagnostic criteria for AIH, with their limitations and utility, and with an emphasis on the role of liver histology in the diagnosis and management of AIH. |
| first_indexed | 2024-03-08T11:00:22Z |
| format | Article |
| id | doaj.art-a4fe36b733824ad59b4958054a4b25b9 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-08T11:00:22Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-a4fe36b733824ad59b4958054a4b25b92024-01-26T16:01:57ZengMDPI AGDiagnostics2075-44182024-01-0114221010.3390/diagnostics14020210Autoimmune Hepatitis: From Evolution to Current Status—A Pathologist’s PerspectivePuja Sakhuja0Surbhi Goyal1Department of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi 110002, IndiaDepartment of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi 110002, IndiaAutoimmune hepatitis (AIH) is a chronic, relapsing and remitting, immune-mediated liver disease that progresses to cirrhosis if left untreated. A significant number of patients may present with acute hepatitis or acute liver failure, which are often misdiagnosed as toxic liver injury. AIH shows a preponderance in young women but may be seen in children and the elderly. Diagnosis requires the integration of clinical, biochemical, and serologic parameters, along with supportive liver histology and exclusion of other causes of liver disease. Liver biopsy is a prerequisite for diagnosis of AIH, to assess severity and stage of disease, exclude other entities, and recognize any concurrent morbidities. No single biomarker or histologic feature is pathognomonic for AIH. The diagnostic and histologic criteria have undergone several modifications since the original scoring system was proposed by the International Autoimmune Hepatitis Group (IAIHG) in 1993. Recently, the IAIHG has proposed consensus recommendations for histologic criteria, relevant for both acute and chronic AIH. This review article will describe the evolving diagnostic criteria for AIH, with their limitations and utility, and with an emphasis on the role of liver histology in the diagnosis and management of AIH.https://www.mdpi.com/2075-4418/14/2/210autoimmune hepatitisInternational Autoimmune Hepatitis Groupsimplified diagnostic criteriahistologyplasma cell clusterslobular hepatitis |
| spellingShingle | Puja Sakhuja Surbhi Goyal Autoimmune Hepatitis: From Evolution to Current Status—A Pathologist’s Perspective Diagnostics autoimmune hepatitis International Autoimmune Hepatitis Group simplified diagnostic criteria histology plasma cell clusters lobular hepatitis |
| title | Autoimmune Hepatitis: From Evolution to Current Status—A Pathologist’s Perspective |
| title_full | Autoimmune Hepatitis: From Evolution to Current Status—A Pathologist’s Perspective |
| title_fullStr | Autoimmune Hepatitis: From Evolution to Current Status—A Pathologist’s Perspective |
| title_full_unstemmed | Autoimmune Hepatitis: From Evolution to Current Status—A Pathologist’s Perspective |
| title_short | Autoimmune Hepatitis: From Evolution to Current Status—A Pathologist’s Perspective |
| title_sort | autoimmune hepatitis from evolution to current status a pathologist s perspective |
| topic | autoimmune hepatitis International Autoimmune Hepatitis Group simplified diagnostic criteria histology plasma cell clusters lobular hepatitis |
| url | https://www.mdpi.com/2075-4418/14/2/210 |
| work_keys_str_mv | AT pujasakhuja autoimmunehepatitisfromevolutiontocurrentstatusapathologistsperspective AT surbhigoyal autoimmunehepatitisfromevolutiontocurrentstatusapathologistsperspective |