The variant forms of autoimmune hepatitis

[Guest guest]

The variant forms of autoimmune hepatitis.

Czaja AJ

Mayo Clinic, Rochester, Minnesota, USA.

OBJECTIVES: To review the diagnostic criteria for autoimmune

hepatitis, to characterize the variant forms of autoimmune hepatitis,

and to indicate appropriate therapies for this condition. DATA

SOURCES: A MEDLINE search (1990 to 1995) of the English-language

literature, review of a personal library of journals and reprints

(1975 to 1995), and review of references selected from the

bibliographies of identified articles. Terms used in the MEDLINE

search included the names of all autoimmune liver diseases, viral

hepatitis and autoimmunity, cryptogenic hepatitis, and overlap

syndromes. STUDY SELECTION: All articles that discussed atypical

clinical features, mixed diagnostic findings, and variations in

treatment response were selected. DATA EXTRACTION: Data were selected

from 548 articles. DATA SYNTHESIS: Standardized criteria permit the

confident diagnosis of autoimmune hepatitis, but they exclude many

patients who have features suggesting autoimmunity. Such patients

have findings indicative of both autoimmune hepatitis and another

disorder (overlap syndromes) or findings that are inconsistent with

the classic definition of autoimmune hepatitis (outlier syndromes).

Overlap syndromes include combinations of autoimmune hepatitis and

primary biliary cirrhosis, primary sclerosing cholangitis, or chronic

viral hepatitis. Treatment of these syndromes requires identification

of the predominant disorder and selection of the most appropriate

drug regimen. Outlier syndromes include autoimmune cholangitis and

cryptogenic chronic hepatitis. Corticosteroids or ursodeoxycholic

acid are treatment options for patients with autoimmune cholangitis;

corticosteroids can also benefit patients with cryptogenic chronic

hepatitis. Grading each clinical feature and developing a composite

score can permit comparison of the variants and a determination of

the similarity between the variants and autoimmune hepatitis.

CONCLUSIONS: Variant forms of autoimmune hepatitis are common.

Recognition of them is important in assessing common pathogenic

mechanisms, developing effective treatment strategies, and refining

classification schemes.

source: http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?

db=m & form=6 & uid=8815758 & Dopt=r

[Guest guest]

In a message dated 12/9/00 10:24:03 PM Pacific Standard Time,

bluupoint@... writes:

<< Variant forms of autoimmune hepatitis are common.

Recognition of them is important in assessing common pathogenic

mechanisms, developing effective treatment strategies, and refining

classification schemes. >>

Thanks, to whoever sent this. While I was aware, from reading, that there

are several forms, my doctor hasn't mentioned them and I had believed the

typology to be of little importance. I hope he's on top of this.

Harper