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hongpinguo 离线
hongpinguo 离线
liziqiang88 离线
Autoimmune hepatitis(摘自pathologyoutline.com)
(1)70% women, usually ages 20-45 years,60% have other autoimmune disorders (rheumatoid arthritis, thyroiditis, Sjogren’s syndrome, ulcerative colitis)。
(2)Symptoms: amenorrhea, arthralgias, symptoms of chronic hepatitis。
(3)Laboratory: viral markers negative, elevated IgG, high ALT and AST (300-500 mg/dl); elevated anti-nuclear antibody, anti-smooth muscle antibody, anti liver-kidney-microsomal antibody, anti-mitochondrial antibody 。
(4)Treatment: steroids (dramatic response); failure to respond suggests diagnosis is wrong。
(5)Micro: dense uniform portal infiltrate with abundance of plasma cells, central vein to portal tract bridging necrosis, extensive piecemeal necrosis, central necrosis with plasma cells, variable eosinophils。
(6)DD: hepatitis A, chronic hepatitis C (less severe and more focal interface hepatitis), primary biliary cirrhosis, primary sclerosing cholangitis, drug/toxin reaction。