Autoimmune hepatitis

Autoimmune liver disease encompasses several disorders (Table 1). Autoimmune hepatitis (AIH) affects mainly women and is characterized histologically by a portal tract mononuclear cell infiltrate disrupting the limiting plate and invading the parenchyma ("interface hepatitis") and serologically by the presence of autoantibodies and increased levels of immunoglobulin G (IgG), in the absence of a known cause. AIH responds to immunosuppressive treatment. It can present insidiously or as an acute hepatitis. The previously accepted requirement of 6-month duration of symptoms before diagnosis can be made has been abandoned and treatment should be instituted as soon as the disease is diagnosed. In this review, we concentrate on those reports that add to our knowledge in terms of pathogenesis, differential diagnosis, treatment, and clinical course. Special attention is given to overlap syndromes.