Autoimmune hepatitis Diagnostic of choice: Difference between revisions
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== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
=== Gold standard/Study of choice: === | === Gold standard/Study of choice: === | ||
*Liver biopsy is the gold standard test for the diagnosis of Autoimmune hepatitis | *Liver biopsy is the gold standard test for the diagnosis of Autoimmune hepatitis<ref name="pmid12362575">{{cite journal |vauthors=Carpenter HA, Czaja AJ |title=The role of histologic evaluation in the diagnosis and management of autoimmune hepatitis and its variants |journal=Clin Liver Dis |volume=6 |issue=3 |pages=685–705 |year=2002 |pmid=12362575 |doi= |url=}}</ref> | ||
*Liver biopsy is performed by following methods: | *Liver biopsy is performed by following methods: | ||
**Percutaneous liver biopsy with or without ultrasound guidance | **Percutaneous liver biopsy with or without ultrasound guidance | ||
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*Bridging necrosis is a finding seen in cirrhosis | *Bridging necrosis is a finding seen in cirrhosis | ||
==Overlap syndrome== | ==Overlap syndrome== | ||
Liver biospy is gold standard for diagnosing overlap syndrome<ref name="pmid20101749">{{cite journal |vauthors=Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, Gores GJ |title=Diagnosis and management of primary sclerosing cholangitis |journal=Hepatology |volume=51 |issue=2 |pages=660–78 |year=2010 |pmid=20101749 |doi=10.1002/hep.23294 |url=}}</ref> | |||
{| class="wikitable" | |||
! colspan="2" | '''Histology findings of overlap syndrome''' | |||
|- | |||
|Types | |||
|Biopsy findings | |||
|- | |||
|AIH-PBC | |||
| | |||
* Interface hepatitis | |||
* Destructive cholangitis (florid duct lesions) | |||
|- | |||
|AIH-PSC | |||
| | |||
* Interface hepatitis | |||
* Ductopenia | |||
* Portal edema or fibrous | |||
* Obliterative fibrous cholangitis (rare) | |||
|- | |||
|AIH-cholestatic syndrome | |||
| | |||
* Interface hepatitis | |||
* Destructive cholangitis or bile duct loss | |||
|} | |||
==References== | ==References== | ||
Revision as of 02:46, 31 December 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: :Manpreet Kaur, MD [2]
Overview
Diagnostic Study of Choice
Gold standard/Study of choice:
- Liver biopsy is the gold standard test for the diagnosis of Autoimmune hepatitis[1]
- Liver biopsy is performed by following methods:
- Percutaneous liver biopsy with or without ultrasound guidance
- Transjugular liver biopsy
Histology findings usually found on biopsy:
- Interface hepatitis (ie, piecemeal necrosis) is the histological hallmark
- Portal lesion spares the biliary tree
- This involves most of the lobule.
- Lobular collapse which is best identified by reticulin staining
- There is lymphoplasmacytic periportal infiltrate which invade the limiting plate
- There is an abundance of plasma cells and eosinophils are usually present
- A plasma cell infiltrate lead to plasma cell hepatitis If it involves lobules called lobular or whole liver known as panacinar hepatitis
- Fibrosis causes distortion of the hepatic lobule and the appearance of regenerative nodules, resulting in cirrhosis
- Bridging necrosis is a finding seen in cirrhosis
Overlap syndrome
Liver biospy is gold standard for diagnosing overlap syndrome[2]
| Histology findings of overlap syndrome | |
|---|---|
| Types | Biopsy findings |
| AIH-PBC |
|
| AIH-PSC |
|
| AIH-cholestatic syndrome |
|
References
- ↑ Carpenter HA, Czaja AJ (2002). "The role of histologic evaluation in the diagnosis and management of autoimmune hepatitis and its variants". Clin Liver Dis. 6 (3): 685–705. PMID 12362575.
- ↑ Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, Gores GJ (2010). "Diagnosis and management of primary sclerosing cholangitis". Hepatology. 51 (2): 660–78. doi:10.1002/hep.23294. PMID 20101749.