Differentiating between autoimmune hepatitis, PBC and ...

[Pages:53]Differentiating between autoimmune hepatitis, primary biliary cirrhosis and

overlap syndrome

Dong Hyun Sinn, M.D., Ph.D.

Department of Medicine, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea

Contents

Why is differentiation necessary? Why is differentiation difficult? How can we differentiate?

AIH: pathogenesis

Kriese et al., Frontline Gastroenterology 2013;4:2

T-cell mediated immune attack

Un-resolving inflammation of

the liver

Manns et al., AASLD practice guideline 2010

Characteristics

Circulating autoantibodies Elevated immunoglobulins Dramatic response to immune suppression

Jeong SH, KASL meeting 2011:S44

Autoantibodies

Manns et al., AASLD practice guideline 2010

Histology

Manns et al., AASLD practice guideline 2010

Diagnosis

Manns et al., AASLD practice guideline 2010

Characteristics of AIH in Korean

Mean age = 52.8 years (19-87) 88% female

Multicenter, 343 patients Mostly type I AIH Presentation

Asymptomatic (30.6%) Cirrhotic (22.7%) Decompensation (4.3%)

Kim BH et al., J Gastroenterol Hepatol 2013;28:128

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