Clinical features and management of autoimmune hepatitis

Table 1 Histologic differential diagnosis of chronic hepatitis

Histologic differential diagnosis
Autoimmune liver disease
Autoimmune hepatitis
Primary biliary cirrhosis
Primary sclerosing cholangitis
Variant syndromes
Chronic viral hepatitis
Chronic hepatitis B
Chronic hepatitis C
Chronic hepatitis delta
Chronic hepatitis due to other viruses
Chronic drug-induced hepatitis
Alpha1-antitrypsin deficiency
Wilson’s disease
Granulomatous hepatitis
Systemic lupus erythematosus
Graft-versus-host disease
Alcoholic steatohepatitis
Nonalcoholic steatohepatitis

Table 2 Classification of autoimmune hepatitis

Disorder	Characteristic autoantibodies
Type 1	ANA (antinuclear antibody)
	SMA (smooth muscle antibody)
	AAA (anti-actin antibody)
	Anti SLA/LP (anti-soluble liver antigen/liver-pancreas antigen)
	pANCA (atypical perinuclear antineutrophil cytoplasmic antibody)
	AMA (antimitochondrial antibody)1
Type 2	ALKM-1 (anti-liver/kidney microsome-1)
	ALC-1 (anti-liver cytosol-1)

¹Occurs infrequently in association with other characteristic autoantibodies. It may be the sole antibody present in AMA-negative autoimmune hepatitis, also referred to as the overlap syndrome.

Table 3 Drugs used in standard treatment of autoimmune hepatitis in adults

Regimen	Single-drug therapy	Combination therapy
Initial	Prednisone 20-60 mg/d	Prednisone 15-30 mg/d and azathioprine 50-100 mg/d
Maintenance	Prednisone 5-15 mg/d or azathioprine 50-200 mg/d	Prednisone 5-10 mg/d and azathioprine 50-150 mg/d