Ebook Sherlock’s diseases of the liver and biliary system (13/E): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Sherlock’s diseases of the liver and biliary system (13/E): Part 2
Ebook Sherlock’s diseases of the liver and biliary system (13/E): Part 2
Chapter 19Autoimmune Hepatitis and OverlapSyndromesAshnila Janmohamed and Gideon M. HirschfieldCentreJbr Liver Research, NIIIR Biomedical Research Cen Ebook Sherlock’s diseases of the liver and biliary system (13/E): Part 2ntre, University of Birmingham, Birmingham, UKLEARNING POINTS•Autoimmune hepatitis (AIH) is an immune - mediated liver disease that can present in all ages and races and both sexes.•Disease presentation is variable, ranging from asymptomatic disease to fulminant liver failure.•There is an absence of Ebook Sherlock’s diseases of the liver and biliary system (13/E): Part 2 a specific diagnostic marker, hence diagnosis is made by exclusion of alternative liver disease and precipitants, for example, drugs and viruses.•CliEbook Sherlock’s diseases of the liver and biliary system (13/E): Part 2
nically, AIM is characterized by raised serum alanine aminotransferase, hypergammaglobulinaemia, autoantibodies, and interface hepatitis. SeropositiviChapter 19Autoimmune Hepatitis and OverlapSyndromesAshnila Janmohamed and Gideon M. HirschfieldCentreJbr Liver Research, NIIIR Biomedical Research Cen Ebook Sherlock’s diseases of the liver and biliary system (13/E): Part 2dney microsomal 1 and/or liver cytosol 1 (type 2 disease).•The cornerstone of therapy is immunosuppression using corticosteroids and azathioprine with the majority of patients achieving remission, reflecting that AIH is normally treatment responsive.•Liver transplantation is indicated in patients wh Ebook Sherlock’s diseases of the liver and biliary system (13/E): Part 2o present with fulminant liver failure or have end - stage liver disease.•Lack of response to immunosuppression should prompt confirmation of complianEbook Sherlock’s diseases of the liver and biliary system (13/E): Part 2
ce, exclusion of alternative/additional aetiology such as primary biliary or primary sclerosing cholangitis, and initiation of second - line967therapyChapter 19Autoimmune Hepatitis and OverlapSyndromesAshnila Janmohamed and Gideon M. HirschfieldCentreJbr Liver Research, NIIIR Biomedical Research Cen Ebook Sherlock’s diseases of the liver and biliary system (13/E): Part 2nAutoimmune hepatitis (A1H) is a heterogeneous immune -mediated liver disease that, in most cases, has effective treatment when diagnosed promptly and treated judiciously with classical immunosuppression focused on corticosteroids and azathioprine. The spectrum of presentation alongside the absence Ebook Sherlock’s diseases of the liver and biliary system (13/E): Part 2of clear pathophysiology and non - specific diagnostic markers results in a chronic, rare, and progressive immune - mediated liver disease, which hasEbook Sherlock’s diseases of the liver and biliary system (13/E): Part 2
ongoing unmet needs. Clinically, in its classical form, patients with A1H arc characterized by raised scrum alanine transaminase (ALT) activity, hyperChapter 19Autoimmune Hepatitis and OverlapSyndromesAshnila Janmohamed and Gideon M. HirschfieldCentreJbr Liver Research, NIIIR Biomedical Research Cen Ebook Sherlock’s diseases of the liver and biliary system (13/E): Part 2on of drug precipitants (prescribed, ‘over - the - counter’, or herbal), alternative aetiologies of liver disease and confirmation of negative viral studies are always required (Fig, 19.1).968Evaluating the patient tor autoimmune liver diseaseCholestatic profileALP.‘y-GT elevated with ALT/AST <5 X U Ebook Sherlock’s diseases of the liver and biliary system (13/E): Part 2LN? PBC ? PSCSymptoms -Fatigue, prunbs abdominal pain, jaunice. dark unne, Gl symptomsDrug history (pcescrlbed/non-prescribed) Past medical history (7Ebook Sherlock’s diseases of the liver and biliary system (13/E): Part 2
inflammatory bơAOl disease. ? other autoimmune disease) Family history Smoking'alcohol useHepatitic profileALT/AST elevated without sxjnificant ALP eChapter 19Autoimmune Hepatitis and OverlapSyndromesAshnila Janmohamed and Gideon M. HirschfieldCentreJbr Liver Research, NIIIR Biomedical Research Cen Ebook Sherlock’s diseases of the liver and biliary system (13/E): Part 2r1Immunology testingSerum immunoglobulins:IgG clevatson associated with AIHIgM elevation associated with P8C igG4 elevation associated with autoimmune pancreatitiSi'sclerosing cholangitis Ebook Sherlock’s diseases of the liver and biliary system (13/E): Part 2Chapter 19Autoimmune Hepatitis and OverlapSyndromesAshnila Janmohamed and Gideon M. HirschfieldCentreJbr Liver Research, NIIIR Biomedical Research CenGọi ngay
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