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Autoimmune Liver Diseases

Autoimmune Liver Diseases. Nasser Rakhshani MD Associate Professor of Pathology Firoozgar Hospital Tehran University of Medical Sciences. Histologic forms. Acute AIH Chronic AIH AIH with overlap syndrome. Acute AIH. AIH variants. Why liver biopsy?. Diagnosing Grading and staging

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Autoimmune Liver Diseases

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  1. Autoimmune Liver Diseases Nasser Rakhshani MD Associate Professor of Pathology Firoozgar Hospital Tehran University of Medical Sciences

  2. Histologic forms • Acute AIH • Chronic AIH • AIH with overlap syndrome

  3. Acute AIH

  4. AIH variants

  5. Why liver biopsy? • Diagnosing • Grading and staging • Response assessment

  6. Why liver biopsy? • Cryptogenic hepatitis • HCV hepatitis +/- AIH • IgG4 sclerosing cholangitis • PBC • PSC • Autoimmune cholangitis • NASH

  7. IgG4 sclerosing cholangitis

  8. Be careful ! • Bile duct destruction is generally not prominent in AIH, but up to 12% of biopsies may show duct destruction • Thirty-four percent of patients with AIH have few or no plasma cells and their absence does not preclude the diagnosis

  9. Impact of histology on treatment

  10. Response to treatment • Histologic improvement lags behind clinical and laboratory improvement by 3 to 6 months • Histologic findings that predict a high (>50%) probability of relapse after drug withdrawal must be documented so that premature withdrawal of medication can be averted • INTERFACE HEPATITIS, PORTAL INFLAMMATION AND PROGRESSION TO CIRRHOSIS

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