Autoimmune hepatitis - Revision history

Michael: PBC -> change to newer term

2021-09-30T21:01:28Z

PBC -> change to newer term

← Older revision		Revision as of 21:01, 30 September 2021
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	\| Micro = interface hepatitis with plasma cells, +/- bile duct injury		\| Micro = interface hepatitis with plasma cells, +/- bile duct injury
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[viral hepatitis]], [[primary biliary ~~cirrhosis~~]], AIH-[[PBC]] overlap, [[PSC]]-AIH overlap, [[drug reaction]]		\| LMDDx = [[viral hepatitis]], [[primary biliary cholangitis]], AIH-[[PBC]] overlap, [[PSC]]-AIH overlap, [[drug reaction]]
	\| Stains =		\| Stains =
	\| IHC =		\| IHC =
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	\| Prognosis = poor without treatment		\| Prognosis = poor without treatment
	\| Other =		\| Other =
	\| ClinDDx = [[primary biliary ~~cirrhosis~~]], [[primary sclerosing cholangitis]]		\| ClinDDx = [[primary biliary cholangitis]], [[primary sclerosing cholangitis]]
	\| Tx = corticosteroids, immunosuppression, liver transplant (end stage)		\| Tx = corticosteroids, immunosuppression, liver transplant (end stage)
	}}		}}
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	*[[Viral hepatitis]] - should have plasma cells.		*[[Viral hepatitis]] - should have plasma cells.
	*[[Drug-induced liver injury]] - milder changes than AIH, portal [[neutrophil]]s and [[cholestasis]].<ref>{{Cite journal \| last1 = Suzuki \| first1 = A. \| last2 = Brunt \| first2 = EM. \| last3 = Kleiner \| first3 = DE. \| last4 = Miquel \| first4 = R. \| last5 = Smyrk \| first5 = TC. \| last6 = Andrade \| first6 = RJ. \| last7 = Lucena \| first7 = MI. \| last8 = Castiella \| first8 = A. \| last9 = Lindor \| first9 = K. \| title = The use of liver biopsy evaluation in discrimination of idiopathic autoimmune hepatitis versus drug-induced liver injury. \| journal = Hepatology \| volume = 54 \| issue = 3 \| pages = 931-9 \| month = Sep \| year = 2011 \| doi = 10.1002/hep.24481 \| PMID = 21674554 }}</ref>		*[[Drug-induced liver injury]] - milder changes than AIH, portal [[neutrophil]]s and [[cholestasis]].<ref>{{Cite journal \| last1 = Suzuki \| first1 = A. \| last2 = Brunt \| first2 = EM. \| last3 = Kleiner \| first3 = DE. \| last4 = Miquel \| first4 = R. \| last5 = Smyrk \| first5 = TC. \| last6 = Andrade \| first6 = RJ. \| last7 = Lucena \| first7 = MI. \| last8 = Castiella \| first8 = A. \| last9 = Lindor \| first9 = K. \| title = The use of liver biopsy evaluation in discrimination of idiopathic autoimmune hepatitis versus drug-induced liver injury. \| journal = Hepatology \| volume = 54 \| issue = 3 \| pages = 931-9 \| month = Sep \| year = 2011 \| doi = 10.1002/hep.24481 \| PMID = 21674554 }}</ref>
	*[[Primary biliary ~~cirrhosis~~]].		*[[Primary biliary cholangitis]].
	*AIH-PBC overlap.		*AIH-PBC overlap.
	*PSC-AIH overlap.		*PSC-AIH overlap.
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	serology is suggested, if not done.		serology is suggested, if not done.

	The histology is not suggestive of primary biliary ~~cirrhosis~~.		The histology is not suggestive of primary biliary cholangitis.
	</pre>		</pre>

Mitchell: /* Images */ a case of aih without significant fibrosis

2016-07-18T20:33:38Z

Images: a case of aih without significant fibrosis

← Older revision		Revision as of 20:33, 18 July 2016
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	===Images===		===Images===
			Table show [[AIH-nonCIR]]
			{\|
			[[File:1 AIH 2 680x512px.tif\|Expanded portal regions with dull edges suggestive of interface hepatitis (40X).]]
			[[File:2 AIH 2 680x512px.tif\|PAS without diastase shows interface hepatitis (200X).]]
			[[File:3 AIH 2 680x512px.tif\|Abundant plasma cells seen at higher power (400X).]]
			[[File:4 AIH 2 680x512px.tif\|PAS with diastase shows intense inflammation of portal triad stroma, with some reduplication of ductal epithelium. The patient’s vial serology and anti-microbial antibody were negative. (200X).]]
			\|}
			Autoimmune hepatitis. Expanded portal regions with dull edges suggestive of interface hepatitis (UL 40X). PAS without diastase shows interface hepatitis (UR 200X). Abundant plasma cells seen at higher power (LL 400X). PAS with diastase shows intense inflammation of portal triad stroma, with some reduplication of ductal epithelium. The patient’s vial serology and anti-microbial antibody were negative. (LR 200X).

	Table show [[AIH-CIR]]		Table show [[AIH-CIR]]
	{\|		{\|

Mitchell: /* Images */

2016-07-08T13:59:55Z

Images

← Older revision		Revision as of 13:59, 8 July 2016
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	[[File:CIrrhosis Mult Cause - 1 - 400X 1369x1024px shot 03.tif\|PAS without diastase shows piecemeal necrosis (not very good on wedge biopsies in my experience)]]		[[File:CIrrhosis Mult Cause - 1 - 400X 1369x1024px shot 03.tif\|PAS without diastase shows piecemeal necrosis (not very good on wedge biopsies in my experience)]]
	\|}		\|}
	Chronic hepatitis with changes of autoimmune hepatitis and with cirrhosis and steatosis. Trichrome shows blue fibrosis about hepatocyte nodules with steatosis (UL, 40X). Inflammation includes occasional plasma cells (UR, 400X, yellow arrowhead at plasma cell), consistent with history of autoimmune hepatitis. Ballooning degeneration is present (LL, 400X). PAS without diastase shows piecemeal necrosis, (LR, 400X). The patient had also had diabetes. ~~[[User:Mitchell\|Mitchell Wachtel (talk)]] ([[User talk:Mitchell\|talk]]) 09:56, 8 July 2016 (EDT)~~		Chronic hepatitis with changes of autoimmune hepatitis and with cirrhosis and steatosis. Trichrome shows blue fibrosis about hepatocyte nodules with steatosis (UL, 40X). Inflammation includes occasional plasma cells (UR, 400X, yellow arrowhead at plasma cell), consistent with history of autoimmune hepatitis. Ballooning degeneration is present (LL, 400X). PAS without diastase shows piecemeal necrosis, (LR, 400X). The patient had also had diabetes.

Mitchell: /* Images */ Just to improve clarity

2016-07-08T13:57:19Z

Images: Just to improve clarity

← Older revision		Revision as of 13:57, 8 July 2016
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	[[File:CIrrhosis Mult Cause - 1 - 400X 1369x1024px shot 03.tif\|PAS without diastase shows piecemeal necrosis (not very good on wedge biopsies in my experience)]]		[[File:CIrrhosis Mult Cause - 1 - 400X 1369x1024px shot 03.tif\|PAS without diastase shows piecemeal necrosis (not very good on wedge biopsies in my experience)]]
	\|}		\|}
	Chronic ~~hepaititis~~ with changes of autoimmune hepatitis and with cirrhosis and steatosis. Trichrome shows blue fibrosis about hepatocyte nodules with steatosis (UL:, 40X). Inflammation includes occasional plasma cells (UR, 400X, yellow arrowhead at plasma cell), consistent with history of autoimmune hepatitis. Ballooning degeneration is present (LL, 400X). PAS without diastase shows piecemeal necrosis, (LR, 400X ~~stain~~). The patient had also had diabetes.		Chronic hepatitis with changes of autoimmune hepatitis and with cirrhosis and steatosis. Trichrome shows blue fibrosis about hepatocyte nodules with steatosis (UL, 40X). Inflammation includes occasional plasma cells (UR, 400X, yellow arrowhead at plasma cell), consistent with history of autoimmune hepatitis. Ballooning degeneration is present (LL, 400X). PAS without diastase shows piecemeal necrosis, (LR, 400X). The patient had also had diabetes. [[User:Mitchell\|Mitchell Wachtel (talk)]] ([[User talk:Mitchell\|talk]]) 09:56, 8 July 2016 (EDT)

Mitchell: /* Images */ add AIH with cirrhosis

2016-07-06T13:38:19Z

Images: add AIH with cirrhosis

← Older revision		Revision as of 13:38, 6 July 2016
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	*AIH-PBC overlap.		*AIH-PBC overlap.
	*PSC-AIH overlap.		*PSC-AIH overlap.





	===Images===		===Images===
			Table show [[AIH-CIR]]
			{\|
			[[File:CIrrhosis Mult Cause - 1 - 400X 1369x1024px shot 04.tif\|Trichrome shows blue fibrosis about hepatocyte nodules]]
			[[File:CIrrhosis Mult Cause - 1 - 400X 1369x1024px shot 01.tif\|Inflammation includes occasional plasma cells (yellow arrowhead)]]
			[[File:CIrrhosis Mult Cause - 1 - 400X 1369x1024px shot 02.tif\|Ballooning degeneration is present]]
			[[File:CIrrhosis Mult Cause - 1 - 400X 1369x1024px shot 03.tif\|PAS without diastase shows piecemeal necrosis (not very good on wedge biopsies in my experience)]]
			\|}
			Chronic hepaititis with changes of autoimmune hepatitis and with cirrhosis and steatosis. Trichrome shows blue fibrosis about hepatocyte nodules with steatosis (UL:, 40X). Inflammation includes occasional plasma cells (UR, 400X, yellow arrowhead at plasma cell), consistent with history of autoimmune hepatitis. Ballooning degeneration is present (LL, 400X). PAS without diastase shows piecemeal necrosis, (LR, 400X stain). The patient had also had diabetes.


	<gallery>		<gallery>
	Image:Autoimmune_hepatitis_-_low_mag.jpg \| AIH - low mag. (WC)		Image:Autoimmune_hepatitis_-_low_mag.jpg \| AIH - low mag. (WC)

Michael: /* Microscopic */

2015-09-01T18:56:39Z

Microscopic

← Older revision		Revision as of 18:56, 1 September 2015
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	*[[Viral hepatitis]] - should have plasma cells.		*[[Viral hepatitis]] - should have plasma cells.
	*[[Drug-induced liver injury]] - milder changes than AIH, portal [[neutrophil]]s and [[cholestasis]].<ref>{{Cite journal \| last1 = Suzuki \| first1 = A. \| last2 = Brunt \| first2 = EM. \| last3 = Kleiner \| first3 = DE. \| last4 = Miquel \| first4 = R. \| last5 = Smyrk \| first5 = TC. \| last6 = Andrade \| first6 = RJ. \| last7 = Lucena \| first7 = MI. \| last8 = Castiella \| first8 = A. \| last9 = Lindor \| first9 = K. \| title = The use of liver biopsy evaluation in discrimination of idiopathic autoimmune hepatitis versus drug-induced liver injury. \| journal = Hepatology \| volume = 54 \| issue = 3 \| pages = 931-9 \| month = Sep \| year = 2011 \| doi = 10.1002/hep.24481 \| PMID = 21674554 }}</ref>		*[[Drug-induced liver injury]] - milder changes than AIH, portal [[neutrophil]]s and [[cholestasis]].<ref>{{Cite journal \| last1 = Suzuki \| first1 = A. \| last2 = Brunt \| first2 = EM. \| last3 = Kleiner \| first3 = DE. \| last4 = Miquel \| first4 = R. \| last5 = Smyrk \| first5 = TC. \| last6 = Andrade \| first6 = RJ. \| last7 = Lucena \| first7 = MI. \| last8 = Castiella \| first8 = A. \| last9 = Lindor \| first9 = K. \| title = The use of liver biopsy evaluation in discrimination of idiopathic autoimmune hepatitis versus drug-induced liver injury. \| journal = Hepatology \| volume = 54 \| issue = 3 \| pages = 931-9 \| month = Sep \| year = 2011 \| doi = 10.1002/hep.24481 \| PMID = 21674554 }}</ref>
			*[[Primary biliary cirrhosis]].
			*AIH-PBC overlap.
			*PSC-AIH overlap.

	===Images===		===Images===

Michael: /* Microscopic */

2015-09-01T18:56:06Z

Microscopic

← Older revision		Revision as of 18:56, 1 September 2015
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	**Lots of plasma cells should prompt consideration of AIH.		**Lots of plasma cells should prompt consideration of AIH.
	*Atypical Autoimmune hepatitis may have zone III involvment (lymphoplasmacytic infiltrate)<ref name=pmid19452572>Non-classical phenotypes of autoimmune hepatitis and advances in diagnosis and treatment. Czaja AJ, Bayraktar Y. World J Gastroenterol. 2009 May 21;15(19):2314-28. Review. PMID 19452572.</ref> and a normal IgG.<ref>FW. 21 September 2009.</ref>		*Atypical Autoimmune hepatitis may have zone III involvment (lymphoplasmacytic infiltrate)<ref name=pmid19452572>Non-classical phenotypes of autoimmune hepatitis and advances in diagnosis and treatment. Czaja AJ, Bayraktar Y. World J Gastroenterol. 2009 May 21;15(19):2314-28. Review. PMID 19452572.</ref> and a normal IgG.<ref>FW. 21 September 2009.</ref>

			DDx:
			*[[Viral hepatitis]] - should have plasma cells.
			*[[Drug-induced liver injury]] - milder changes than AIH, portal [[neutrophil]]s and [[cholestasis]].<ref>{{Cite journal \| last1 = Suzuki \| first1 = A. \| last2 = Brunt \| first2 = EM. \| last3 = Kleiner \| first3 = DE. \| last4 = Miquel \| first4 = R. \| last5 = Smyrk \| first5 = TC. \| last6 = Andrade \| first6 = RJ. \| last7 = Lucena \| first7 = MI. \| last8 = Castiella \| first8 = A. \| last9 = Lindor \| first9 = K. \| title = The use of liver biopsy evaluation in discrimination of idiopathic autoimmune hepatitis versus drug-induced liver injury. \| journal = Hepatology \| volume = 54 \| issue = 3 \| pages = 931-9 \| month = Sep \| year = 2011 \| doi = 10.1002/hep.24481 \| PMID = 21674554 }}</ref>

	===Images===		===Images===

Michael: /* References */

2014-10-17T14:47:12Z

References

← Older revision		Revision as of 14:47, 17 October 2014
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	[[Category:Liver pathology]]		[[Category:Liver pathology]]
	[[Category:Diagnosis]]		[[Category:Diagnosis]]
			[[Category:Medical liver disease]]

Michael at 15:23, 5 September 2014

2014-09-05T15:23:38Z

← Older revision		Revision as of 15:23, 5 September 2014
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	\| Micro = interface hepatitis with plasma cells, +/- bile duct injury		\| Micro = interface hepatitis with plasma cells, +/- bile duct injury
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[viral hepatitis]], [[primary biliary cirrhosis]], AIH-PBC overlap, [[drug reaction]]		\| LMDDx = [[viral hepatitis]], [[primary biliary cirrhosis]], AIH-[[PBC]] overlap, [[PSC]]-AIH overlap, [[drug reaction]]
	\| Stains =		\| Stains =
	\| IHC =		\| IHC =

Michael: /* Microscopic */

2014-07-07T15:34:57Z

Microscopic

← Older revision		Revision as of 15:34, 7 July 2014
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	***Lymphoplasmacytic infiltration of portal tracts / lobule.		***Lymphoplasmacytic infiltration of portal tracts / lobule.
	****Periportal [[plasma cells]] - '''key feature'''.<ref>{{Ref PCPBoD8\|448}}</ref>		****Periportal [[plasma cells]] - '''key feature'''.<ref>{{Ref PCPBoD8\|448}}</ref>
	**Emperipolesis - one cell penetrates into another one (uncommon finding).		**[[Emperipolesis]] - one cell penetrates into another one (uncommon finding).
	**Hepatic rosette - inflammatory cells around reactive hepatocytes.<ref name=pmid20527613>{{Cite journal \| last1 = Malik \| first1 = TA. \| last2 = Saeed \| first2 = S. \| title = Autoimmune hepatitis: a review. \| journal = J Pak Med Assoc \| volume = 60 \| issue = 5 \| pages = 381-7 \| month = May \| year = 2010 \| doi = \| PMID = 20527613 \| url=http://www.jpma.org.pk/full_article_text.php?article_id=2051 }}</ref>		**Hepatic rosette - inflammatory cells around reactive hepatocytes.<ref name=pmid20527613>{{Cite journal \| last1 = Malik \| first1 = TA. \| last2 = Saeed \| first2 = S. \| title = Autoimmune hepatitis: a review. \| journal = J Pak Med Assoc \| volume = 60 \| issue = 5 \| pages = 381-7 \| month = May \| year = 2010 \| doi = \| PMID = 20527613 \| url=http://www.jpma.org.pk/full_article_text.php?article_id=2051 }}</ref>
	*Compatible:		*Compatible: