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Treatment Strategies for Autoimmune Hepatitis

Some while after the entity “autoimmune hepatitis” (AIH) was first recognized in the late 1950s, it was realized that patients with this disease may present with diverse disease manifestations ranging from acute fulminant hepatic failure to asymptomatic disease. Thus the typical presentation originally described, of a young woman with malaise, secondary amenorrhea, arthralgia, and jaundice is far from universal. This disease may affect individuals of all ages although presentation with burned out cirrhosis with evidence of liver failure is more typically seen in older patients. In children and young adults particularly, it is now appreciated that AIH commonly exists concurrently with primary sclerosing cholangitis (PSC). A recent report suggests that routine magnetic resonance cholangiography in 78 consecutive adult patients with AIH indicated that 10% had an abnormal magnetic resonance cholangiogram (MRC).