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Severe autoimmune hepatitis first presenting in the early post partum period
Douglas Samuel1, Stephen Riordan, Simone Strasser
1AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Camperdown, Sydney, Australia.
Background & Aims:
Autoimmune hepatitis (AIH) may run an aggressive clinical course if untreated. The influence of pregnancy on AIH is variable. Both flares in disease activity and remissions, often followed by a post partum flare, are well recognized. In contrast, definite AIH first presenting in the early post partum period has not been reported.
Methods:
We discuss a case series of 5 patients who developed severe AIH within 4 months post partum.
Results:
The diagnosis of AIH was definite based on internationally accepted criteria. Liver injury responded to conventional immunosuppressive therapy in all patients. Immune reactivation in the early post partum period may contribute to this entity.
Conclusions:
AIH should be considered in the differential diagnosis of liver dysfunction first presenting in the early post partum period.