Hepatitis autoinmune: manifestaciones, diagnóstico y tratamiento.

Abstract

Autoimmune hepatitis has a global distribution; it can affect patients of both sexes and all ages. The incidence of autoimmune hepatitis varies according to ethnic groups and has been associated with genetic predisposition, occurs after exposure of antigens or other factors that affect the presentation of autoantigens, activation of immunites and proliferation of effector cells. Some viruses, bacteria and medications have been suggested as triggers. The clinic can vary from an asymptomatic condition to chronic or fulminant hepatitis. The diagnosis is based on the exclusion of other liver diseases, the detection of clinical and biochemical manifestations, increased immunoglobulins, presence of autoantibodies and compatible histology (infiltrated plasma cells in the periportal area, presence of multinucleated giant cells, necrosis at the interface, lobular infiltrate with focal necrosis). It is classified into two types based on the serum autoantibodies present. The basis of treatment is the administration of steroids, mainly prednisone; and the objective is to achieve remission, histological and biochemical resolution and the disappearance of clinical symptoms.