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Clinical Presentation

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Book cover Autoimmune Hepatitis

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

Waldenstrom was the first to describe what later became recognized as Autoimmune Hepatitis (AIH). No particular ethnicity precludes the development of AIH although its presentation may vary across the world. AIH may present at any age, from infancy through to the elderly. Although more common in women this disease must nevertheless be considered in the differential diagnosis of “hepatitis” in men. When AIH was first recognized as a specific entity it was assumed that the disease was always symptomatic. Manifestations of advanced liver disease were usual at first presentation. The recent introduction of routine screening blood tests indicates that some individuals may have “asymptomatic” AIH. At the other end of the spectrum, the dramatic improvement in the understanding and management of Fulminant Hepatic Failure (FHF) has allowed the recognition of AIH as one of its many causes. Liver transplant saves the lives of most of those who need it, although recurrent AIH in the new liver may develop.

It is important to recognize the change in demography over the last 40 years as the patients who were entered into any one of the three “classic” randomized control trials of immunosuppressive therapy for AIH in the late 1960s do not necessarily represent the patient population seen in the physician’s office or emergency room today. Thus, it is wrong to assume that the therapies shown to be lifesaving in those with advanced liver disease benefit all those given a diagnosis of AIH today, particularly those at the two extremes eluded to above.

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Authors and Affiliations

  1. Department of Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada

    E. Jenny Heathcote

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  1. E. Jenny Heathcote
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Correspondence to E. Jenny Heathcote .

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Editors and Affiliations

  1. Toronto Western Hospital Liver Centre, Department of Medicine, University of Toronto, Bathhurst St. 399, Toronto, M5T 2S8, Ontario, Canada

    Gideon M. Hirschfield

  2. Toronto Western Hospital Liver Centre, University of Toronto, Bathhurst St. 399, Toronto, M5T 2S8, Ontario, Canada

    E. Jenny Heathcote

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Heathcote, E.J. (2012). Clinical Presentation. In: Hirschfield, G., Heathcote, E. (eds) Autoimmune Hepatitis. Clinical Gastroenterology. Springer, New York, NY. https://doi.org/10.1007/978-1-60761-569-9_3

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  • DOI: https://doi.org/10.1007/978-1-60761-569-9_3

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