Laboratory findings in autoimmune hepatitis include the following:
Elevated serum aminotransferase levels (1.5-50 times reference values)
Elevated serum immunoglobulin levels, primarily immunoglobulin G (IgG)
Mild to moderately elevated serum bilirubin and alkaline phosphatase – In 80-90% of patients; a sharp increase in the alkaline phosphatase values during the course of autoimmune disease may reflect the development of primary sclerosing cholangitis (PSC) or the onset of hepatocellular carcinoma as a complication of cirrhosis
Seropositive results for antinuclear antibodies (ANAs), smooth-muscle antibodies (SMAs), or liver-kidney microsomal type 1 (LKM-1) or anti–liver cytosol 1 (anti-LC1) antibodies
Hypoalbuminemia and prolongation of prothrombin time – Markers of severe hepatic synthetic dysfunction, which may be observed in active disease or decompensated cirrhosis
Coombs-positive hemolytic anemia
elevated erythrocyte sedimentation rate
eosinophillia – not common
Can clarify the suspicion of autoimmune hepatitis.
Corticosteroid prednisone with azathioprine has been used for 30 years to treat autoimmune hepatitis by both American and British healthcare professionals.
The occurence of relapse in autoimmune hepatitis is almost 50% within only six months of stopping treatment.
Eighty percent of patients after 3 years of treatment.
Usually reinstitution of the original treatment induces another remission. The problem is relapse recurs after stopping the treatment a second time.
If the patient relapses twice they require indefinite therapy with prednisone and azathioprine.
Transplant of the Liver:
Liver transplant can be used for those with decompensated cirrhosis caused by autoimmune hepatitis. Also for those with fluminant hepatic failure secondary to autoimmune hepatitis.