Case history
Case history
A 45-year-old woman presents with insidious onset of fatigue, malaise, lethargy, anorexia, nausea, abdominal discomfort, mild pruritus, and arthralgia involving the small joints. Her past medical history includes coeliac disease. Physical examination reveals hepatomegaly and spider angiomata.
Other presentations
AIH shows great variability in its clinical manifestations, ranging from asymptomatic patients to those with considerable symptoms or fulminant hepatic failure. Asymptomatic patients are usually identified when abnormal liver enzymes are discovered during routine laboratory screening tests. At the other end of the spectrum are patients who present with an acute, sometimes fulminant picture, characterised by profound jaundice, a prolonged prothrombin time, and aminotransferase values of several thousands. Autoimmune hepatitis is often accompanied by other autoimmune diseases, most commonly thyroiditis, type 1 diabetes, coeliac disease, ulcerative colitis, rheumatoid arthritis, haemolytic anaemia, or idiopathic thrombocytopenic purpura.[3]
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