Published 8 September 2009, doi:10.1136/bmj.b3305
Cite this as: BMJ 2009;339:b3305

Clinical Review

Autoimmune liver disease for the non-specialist

Sofie Decock, hepatologist1, Phyllis McGee, nurse practitioner with interest in autoimmune liver disease2, Gideon M Hirschfield, assistant professor of medicine2

1 AZ Sint-Lucas, Belgium , 2 The Liver Centre, Toronto Western Hospital, Toronto, ON, Canada, M5T 2S8

Correspondence to: Dr Gideon M Hirschfield, Toronto Western Hospital, 399 Bathurst Street, 6B Fell Pavilion, Toronto, ON, M5T 2S8 gideon.hirschfield@uhn.on.ca

The first 150 words of the full text of this article appear below.


Autoimmune liver diseases are chronic diseases, each with a long natural course
Disease need not be symptomatic, but symptoms when present can be challenging to manage
Autoimmune hepatitis is a parenchymal disease, whereas primary biliary cirrhosis and primary sclerosing cholangitis are biliary diseases
Medical management of primary biliary cirrhosis (with ursodeoxycholic acid) and autoimmune hepatitis (with prednisolone and azathioprine) is very successful and transplantation is rarely needed
Primary sclerosing cholangitis lacks effective medical interventions, but transplantation when indicated is highly successful


Autoimmune hepatitis, primary biliary cirrhosis, and sclerosing cholangitis represent perhaps 5% of all liver diseases, although no registries exist to estimate the true prevalence. They are presumed autoimmune conditions, usually considered as a diagnosis after viral, metabolic, and drug induced liver injuries have been excluded. The combination of medical and surgical treatments means that, if appropriately diagnosed and managed, these diseases overall have an excellent prognosis. We review these . . . [Full text of this article]

Biology
Clinical
Symptoms
For healthcare professionals
For patients

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