Autoimmune hepatitis is condition of unknown aetiology which is most commonly seen in young females.

Recognised associations: include other autoimmune disorders, hypergammaglobulinaemia and HLA B8, DR3.

Three types of autoimmune hepatitis have been characterised according to the types of circulating antibodies present:

PC

• may present with signs of chronic liver disease
• acute hepatitis: fever, jaundice etc (only 25% present in this way)
• amenorrhoea (common)

Investigations

• ANA/SMA/LKM1 antibodies, raised IgG levels
• liver biopsy: inflammation extending beyond limiting plate 'piecemeal necrosis', bridging necrosis

Management

• steroids, other immunosuppressants e.g. azathioprine
• liver transplantation