Difference between revisions of "Medical liver disease"
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==Autoimmune hepatitis== | ==Autoimmune hepatitis== | ||
*Abbreviated ''AIH''. | |||
===General=== | ===General=== | ||
*Several criteria exist to diagnose and histology (alone) is '''not''' sufficient. | |||
*Several criteria exist to diagnose. | |||
===Diagnosis=== | ====Diagnosis==== | ||
Simplifed diagnostic criteria (2008):<ref name=pmid19675998>Scoring systems for the diagnosis of autoimmune hepatitis: past, present, and future. Wiegard C, Schramm C, Lohse AW. Semin Liver Dis. 2009 Aug;29(3):254-61. Epub 2009 Aug 12. PMID 19675998</ref> | Simplifed diagnostic criteria (2008):<ref name=pmid19675998>Scoring systems for the diagnosis of autoimmune hepatitis: past, present, and future. Wiegard C, Schramm C, Lohse AW. Semin Liver Dis. 2009 Aug;29(3):254-61. Epub 2009 Aug 12. PMID 19675998</ref> | ||
#Antibody titer. | #Antibody titer. | ||
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**Interface hepatitis (zone 1) - '''key feature'''. | **Interface hepatitis (zone 1) - '''key feature'''. | ||
***Lymphocytic/lymphoplasmacytic infiltration of portal tracts + lobule. | ***Lymphocytic/lymphoplasmacytic infiltration of portal tracts + lobule. | ||
**Emperipolesis - one cell penetrates into another one. | **Emperipolesis - one cell penetrates into another one (uncommon finding). | ||
**Hepatic rosette. | **Hepatic rosette. | ||
**Plasma cells - '''important feature'''. | **Plasma cells - '''important feature'''. | ||
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*Atypical Autoimmune hepatitis may have zone III involvment (lymphoplasmacytic infiltrate)<ref name=pmid19452572>Non-classical phenotypes of autoimmune hepatitis and advances in diagnosis and treatment. Czaja AJ, Bayraktar Y. World J Gastroenterol. 2009 May 21;15(19):2314-28. Review. PMID 19452572.</ref> and a normal IgG.<ref>FW. 21 September 2009.</ref> | *Atypical Autoimmune hepatitis may have zone III involvment (lymphoplasmacytic infiltrate)<ref name=pmid19452572>Non-classical phenotypes of autoimmune hepatitis and advances in diagnosis and treatment. Czaja AJ, Bayraktar Y. World J Gastroenterol. 2009 May 21;15(19):2314-28. Review. PMID 19452572.</ref> and a normal IgG.<ref>FW. 21 September 2009.</ref> | ||
Images: | |||
*[http://www.ajronline.org/cgi/content/full/185/4/971/FIG3 Emperipolesis (ajronline.org)] | *AIH: | ||
*[http://moon.ouhsc.edu/kfung/jty1/Com07/Com07Image/Com705-05b.gif Emperipolesis (ouhsc.edu)] | **[http://commons.wikimedia.org/wiki/File:Autoimmune_hepatitis_-_low_mag.jpg AIH - low mag. (WC)]. | ||
**[http://commons.wikimedia.org/wiki/File:Autoimmune_hepatitis_-_cropped_-_very_high_mag.jpg AIH - cropped - very high mag (WC)]. | |||
**[http://commons.wikimedia.org/wiki/File:Autoimmune_hepatitis_-_intermed_mag.jpg AIH - intermed. mag. (WC)]. | |||
*Emperipolesis: | |||
**[http://www.ajronline.org/cgi/content/full/185/4/971/FIG3 Emperipolesis (ajronline.org)]. | |||
**[http://moon.ouhsc.edu/kfung/jty1/Com07/Com07Image/Com705-05b.gif Emperipolesis (ouhsc.edu)]. | |||
===Treatment=== | ===Treatment=== | ||