British medical bulletin · 2015
Autoimmune hepatitis: an approach to disease understanding and management.
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Corrigan Margaret, Hirschfield Gideon M, Oo Ye H, Adams David H
Аннотация
INTRODUCTION: Autoimmune hepatitis is a chronic immune-mediated liver injury, frequently associated with progression to end-stage liver disease if untreated. Patients commonly present with hepatitis, positive immune serology, elevated immunoglobulins and compatible liver histology, in the absence of an alternative aetiology.
SOURCES OF DATA: Data for this review were obtained using PubMed.
AREAS OF AGREEMENT: Disease usually responds to steroids and azathioprine, and appears to be a manifestation of autoimmune predisposition triggered in genetically susceptible individuals exposed to likely environmental challenges. We provide an up-to-date approach to disease understanding and management along with the clinical approach to diagnosis and current treatment suggestions.
AREAS OF CONTROVERSY: Controversies such as second line therapies and novel markers of disease activity are introduced.
GROWING POINTS: Increased understanding of the immunoregulatory mechanisms behind autoimmune hepatitis has led to opportunities for new therapies. These are developed including a discussion of timely research studies relevant to future therapies for patients.
SOURCES OF DATA: Data for this review were obtained using PubMed.
AREAS OF AGREEMENT: Disease usually responds to steroids and azathioprine, and appears to be a manifestation of autoimmune predisposition triggered in genetically susceptible individuals exposed to likely environmental challenges. We provide an up-to-date approach to disease understanding and management along with the clinical approach to diagnosis and current treatment suggestions.
AREAS OF CONTROVERSY: Controversies such as second line therapies and novel markers of disease activity are introduced.
GROWING POINTS: Increased understanding of the immunoregulatory mechanisms behind autoimmune hepatitis has led to opportunities for new therapies. These are developed including a discussion of timely research studies relevant to future therapies for patients.