Autoimmunhepatitis (AIH)
Zuletzt bearbeitet: Zuletzt revidiert:
Zuletzt revidiert von:Dietrich August
Definition:
Chronische, entzündliche Lebererkrankung mit gestörter Immunregulation unbekannter Genese.
Häufigkeit:
Selten, betrifft zu 80 % Frauen. In jedem Alter möglich; der Häufigkeitsgipfel liegt bei 40–70 Jahren.
Symptome:
Variabel; häufig asymptomatisch; unspezifische Allgemeinsymptome (Antriebslosigkeit, Müdigkeit, Appetitlosigkeit, Übelkeit, abdominale Beschwerden, Gelenkschmerzen).
Befunde:
Klinisch meist unauffällig; ggf. Hepatomegalie/Hepatosplenomegalie und Ikterus.
Diagnostik:
Klinisch unter Zusammenschau der Befunde und Ausschluss von Differenzialdiagnosen. Typisch sind erhöhte Transaminasen, Hypergammaglobulinämie, Autoantikörper (ANA, anti-SMA, anti-LKM1), histologisches Bild und ein Ansprechen auf immunsuppresive Therapie. Bei bis zu 1/3 Leberzirrhose bei Diagnosestellung.
Therapie:
Immunsuppresion, i. d. R. Prednisolon und Azathioprin. Meist lebenslange Therapie. Bei fulminanter Leberinsuffizienz Lebertransplantation.
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- Dietrich August, Dr. med., Arzt in Weiterbildung Innere Medizin, Freiburg
- Terje Johannessen, professor i allmennmedisin, Institutt for samfunnsmedisinske fag, Norges teknisk-naturvitenskapelige universitet, Trondheim
- Eiliv Brenna, avdelingsoverlege, Medisinsk avdeling, Regionsykehuset i Trondheim