Autoimmune Hepatitis

Chronic & progressive hepatitis of unknown etiology.

Pathogenesis

 - T cell-mediated autoimmunity may be due to defect in regulatory T-cells

 - Genetic factors likely play a role

 - Injurious immune reaction may be triggered by viral infections, certain drugs (methyldopa, interferons, nitrofurantoin), & herbal products

Salient features 

 - Clinical

  * female predominance
  * indolent or severe (fulminant hepatitis)
  * cirrhosis in 40% of survivals

 - serological

  * absence of markers of viral infection
  * elevated serum IgG & γ-globulin levels
  * high serum titers of auto-antibodies  

 - Histological

 * lymphocytes & plasma cells in the interface of portal tracts & hepatic lobules