Autoimmune Hepatitis Associated with Other Autoimmune Diseases: A Critical Review

Area of Science:

• Hepatology
• Immunology
• Gastroenterology

Background:

• Autoimmune hepatitis (AIH) is an inflammatory liver condition with genetic, environmental, and immune system influences.
• Patients with AIH often present with other autoimmune disorders affecting various organ systems.
• The co-occurrence of AIH with other autoimmune diseases ranges from 20% to 40%.

Purpose of the Study:

• To review and assess the strength of evidence for associations between AIH and other autoimmune diseases.
• To provide an updated overview of the prevalence, pathogenesis, diagnosis, and treatment of these associated conditions.

Main Methods:

• Literature review and evidence synthesis.
• Analysis of reported prevalence data for AIH co-occurring with other autoimmune conditions.
• Evaluation of proposed pathogenic mechanisms and diagnostic criteria.

Main Results:

• Significant associations exist between AIH and autoimmune thyroiditis, type 1 diabetes mellitus, ulcerative colitis, Crohn disease, and celiac disease.
• Evidence supporting associations between AIH and primary sclerosing cholangitis, primary biliary cholangitis, rheumatoid arthritis, systemic lupus erythematosus, Sjögren syndrome, and vitiligo is weak.
• Prevalence rates of AIH with other autoimmune diseases range from 20% to 40%.

Conclusions:

• AIH frequently coexists with specific autoimmune diseases, notably autoimmune thyroiditis, type 1 diabetes, inflammatory bowel diseases, and celiac disease.
• The pathogenic mechanisms underlying these co-occurrences require further investigation.
• Clinical evaluation for associated autoimmune conditions in AIH patients is crucial for comprehensive management.