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n South African Gastroenterology Review - A review article on autoimmune hepatitis : review
Autoimmune hepatitis has been recognised since 1940s and was then known as chronic active hepatitis (CAH), described as a novel form of hepatitis found in females noted to have hypergammaglobulinaemia. In the 1960s it was noted to respond to corticosteroids, and in 1993, AIH was endorsed as a clinical entity.
AIH is an unresolving chronic inflammatory condition of the liver resulting from an unknown cause. For this to happen there is a complex interaction of trigger factors, autoantigens, genetic predispositions, and immune-regulatory systems.
AIH is characterized by interface hepatitis and piecemeal necrosis, with a plasmalymphocytic infiltration on histological examination. In addition to this there is increased immunoglobulin G (IgG), elevated alanine aminotransferase (ALT) levels, and liver specific and non-liver specific autoantibodies autoantibodies in the serum.
A quick diagnosis and immunosuppressive therapy in patients with AIH can contain the disease activity and result in a normal life expectancy. Early diagnosis however can prove very difficult because of the heterogeneous nature of the clinical picture and the fact that there is no specific tests applicable to all patients.
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