开眼界，谢谢楼主！

请问病人ALT,AST和自身抗体及IgG等情况。

此例浆细胞性界面炎似乎不明显呀，大的汇管区小胆管增生很重怎么解释呢？不大明白，请教博士！

顶啊

 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。

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