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Revista Cubana de Medicina
versão On-line ISSN 1561-302X
Resumo
INFANTE VELAZQUEZ, Mirtha e ARUS SOLER, Enrique. Hepatitis autoinmune. Rev cubana med [online]. 2000, vol.39, n.1, pp. 49-56. ISSN 1561-302X.
This necroinflammatory liver disease of unknown origin was reported for the first time in 1950. It was mainly described in young women. This nosological entity has had several denominations through history. At present, it is known as autoimmune hepatitis. It appears in individuals with certain genetic predisposition when they are exposed to some environmental agent that has not been identified yet, giving rise to an autoimmune mechanism directed to the liver, where a necroinflammatoy process takes place leading to fibrosis and, finally, to cirrhosis. There are 3 types of autoimmune hepatitis: type1 is characterized by the presence of antinuclear antibodies, smooth antimuscle and antiactin; type 2, by the existance of anti- liver/kidney chromosome antibodies; and type 3, by the appearance of antibodies against the soluble antigen. The diagnosis is based on the histological study of the liver and on the presence of the above mentioned antibodies. Monoclonal hypergammaglobulinemia is a laboratory alteration that characterizes the disease. Other lab findings were the elevation of aminotranferases, alkaline phosphatase and bilirubin. The response to the treatment with glucocorticoids is common in this affection. Azathioprine associated with corticosteroids is used in the maintenance therapy in order to prescribe low doses and to avoid their side effects. Azathioprine may be also used alone as a maintenance therapy.
Palavras-chave : LIVER DISEASES; HEPATITIS, AUTOIMMUNE [genetics.].