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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