Start studying Disease Antibodies USMLE 1. Jenkins B, McInnis M, Lewis C. Step-Up to USMLE Step 2 CK. Although the etiology is unclear, it is commonly associated with other autoimmune conditions (e.g., type 1 diabetes mellitus, celiac disease). The mainstay of treatment is non-specific immunosuppression, consisting of steroids with or without azathioprine. Hepatology. Type 1 AIH is characterized by antinuclear antibody or smooth muscle antibody positivity. Like other autoimmune diseases, researchers don't know what causes autoimmune hepatitis for the approximately 100,000-200,000 people living with the condition in the U.S.. AIH symptoms vary, but often include fatigue, itching, aching joints, and abdominal pain. Labs are significant for elevated transaminitis and positive smooth muscle antibody. This is the first reported case of adalimumab-induced autoimmune hepatitis. type 1 AIH (autoimmune hepatitis) most common. Autoimmune hepatitis can present as an acute or even an alarmingly fulminant hepatitis or, conversely, be asymptomatic and recognized only incidentally by routine biochemical tests of liver function. The diagnosis of autoimmune hepatitis (AIH) is based on a combination of clinical, biochemical, immunological, and histological features and the exclusion of other known causes of liver disease (e.g., hepatitis B, hepatitis C, Wilson's disease, nonalcoholic steatohepatitis, and drug‐induced liver disease). She is started on ursodeoxycholic acid and scheduled for an ultrasound to evaluate her hepatobiliary system. Upon laboratory evaluation, she is positive for antinuclear antibodies, anti-Ro, and anti-La antibodies. Learn and reinforce your understanding of Autoimmune hepatitis: Foundations through video. It predominantly affects women. Type 1 autoimmune hepatitis. autoimmune hepatitis. The patient made a full recovery after discontinuation of adalimumab and treatment with steroids. A “chronic hepatitis” pattern showing plasma cell–rich (>30%) infiltrates should prompt serological evaluation to support an autoimmune cause (e.g., ANA, anti–smooth muscle antibodies [ASMA], LKM, serum gamma globulins) and to reasonably exclude other causes of a chronic hepatitis pattern of injury, such as HBV, HCV, HEV, PBC, and obstructive cholangiopathy. c-ANCA - central anti-neutrophilic antibody. Various anti-tissue antibodies became recognized during 1955 to 1965, detected first to nuclear antigens by the lupus erythematosus (LE) cell test and immunofluorescence (IFL) for antinuclear autoantibody, then to a smooth muscle antigen with the true reactant later identified as the microfilament F actin, and then to an antigen enriched in endoplasmic reticulum (microsomes) of liver and kidney cells. Heneghan MA. Epidemiological data refers to the US, unless otherwise specified. Meeting report: International Autoimmune Hepatitis Group. (Sjögren syndrome) Introduction : Autoimmune Antibodies: Disease: Antibodies: Systemic lupus erythematosus : Antinuclear antibody. Autoimmune hepatitis (AIH) is a rare form of chronic liver disease in which the immune system attacks the liver causing inflammation. Autoimmune hepatitis (AIH) associated with lupus-like symptoms, including elevated serum gamma globulin levels, the appearance of antinuclear antibodies (ANAs), fever, and arthralgias, occurs after a median duration of exposure to minocycline of 365 days in females (n=20) and 730 days in males (n=9) [183]. Antimitochondrial antibody. DISCUSSION: ... (ASGPR) antibodies are observed in a myriad of hepatic disorders including PBC, viral and drug induced hepatitis. Smooth muscle antibody in malignant disease. Anti-smooth muscle antibody is a blood test that detects the presence of antibodies against smooth muscle. MyTherapy: Your Med Reminder App. Doctors have identified two main forms of autoimmune hepatitis. Like other autoimmune diseases, researchers don't know what causes autoimmune hepatitis for the approximately 100,000-200,000 people living with the condition in the U.S.. AIH symptoms vary, but often include fatigue, itching, aching joints, and abdominal pain. Clinical presentation varies and patients may be asymptomatic or even show signs of acute liver failure. Simplified criteria for diagnosis of autoimmune hepatitis are based on autoantibodies, serum immunoglobulin G, histologic features, and negative viral serology. Autoimmune hepatitis (AIH) is a chronic inflammatory disease of the liver of unknown aetiology. Search strategy The PubMed, CNKI, WANFANG, … Autoimmune hepatitis (AIH) is a chronic liver disease characterized by a loss of tolerance against self-liver antigens. Autoimmune hepatitis (AIH) is a rare form of chronic hepatitis that predominantly affects women. Thanked 3,374 Times in 907 Posts Reputation: 3384. Autoimmune hepatitis: Clinical manifestations and diagnosis. Because AIH has a 40% mortality in 6 months without treatment, early diagnosis and … Total hepatitis B core antibody (anti-HBc): Appears at the onset of symptoms in acute hepatitis B and persists for life. Treatment consists of immunosuppressive medications such as prednisone and azathioprine. Autoimmune hepatitis is a disease with many open questions regarding pathogenesis, diagnosis and treatment. Consequently, autoimmune hepatitis has … thyroid-stimulating immunoglobulin. Czaja AJ, Morshed SA, Parveen S, Nishioka M. Antibodies to single-stranded and double-stranded DNA in antinuclear antibody-positive type 1-autoimmune hepatitis. The accurate diagnosis and classification of autoimmune hepatitis (AIH) rely upon the detection of characteristic autoantibodies. change in case ascertainment rates. Thread Tools: Search this Thread : Display Modes #1 01-27-2012 bebix. It results from a slow, progressive destruction of the small bile ducts of the liver, causing bile and other toxins to build up in the liver, a condition called cholestasis.Further slow damage to the liver tissue can lead to scarring, fibrosis, and eventually cirrhosis. Autoimmune Hepatitis. Your doctor will use blood tests to look for evidence of autoimmune hepatitis. However, with treatment, the outlook for people with this condition is very good. Antinuclear antibody (ANA), smooth muscle antibody (SMA), and antiliver kidney microsome antibodies (anti-LKM-1) occasionally present. This test includes 3 tests which can help to determine if a person has Autoimmune Hepatitis. Anti LKM-1 antibodies are associated with patients with type 2a and 2b autoimmune hepatitis. In: Post TW, ed. Smooth muscle antibodies; TPMT, Thiopurine methyltransferase. Posts: 1,357 Threads: 194. 1973 Nov; 15 (3):331–344. Diagnosis is established based on positive autoantibodies (e.g., anti-smooth muscle antibodies) and histological findings suggestive of autoimmune hepatitis! Learn antibodies usmle with free interactive flashcards. Liver biopsy. Immunofluorescence pattern of anti‐LC1 antibodies on a rodent liver section (right panel). However, with treatment, the outlook for people with this condition is very good. Rizzetto M, Swana G, Doniach D. Microsomal antibodies in active chronic hepatitis and other disorders. Type 2 autoimmune hepatitis presents with positive anti-liver/anti-kidney microsome (anti-LMK) type 1 antibodies or anti-liver cytosol (anti-LC) type 1 antibodies. Testing a sample of your blood for antibodies can distinguish autoimmune hepatitis from viral hepatitis and other conditions with similar symptoms. Chronic active hepatitis associated … churg-strauss syndrome enzyme myeloperoxidase - microscopic polyangiitis Ulcerative colitis p-ANCA. In view of the relative success of standard treatment, little need to make progress has been felt by the scientific community so far, and due to the relative rarity of the disease, the pharmaceutical industry has not been supportive in developing new treatment approaches. If left untreated, the inflammation causes 'scarring' of the liver (cirrhosis). Autoimmune hepatitis (AIH) is a rare form of chronic liver disease in which the immune system attacks the liver causing inflammation. Diagnosis and Management of Autoimmune Hepatitis Michael P. Manns,1 Albert J. Czaja,2 James D. Gorham,3 Edward L. Krawitt,4 Giorgina Mieli-Vergani,5 Diego Vergani,6 and John M. Vierling7 This guideline has been approved by the American Association for the Study of Liver Diseases (AASLD) and represents the position of the Association. Using our anti-TGR5 antiserum and an anti- 16701 A NEW SUBSTRATE FACILITATES THE DETECTION human TGRS antiserum on whole rat and human liver kryosections, we OF AUTOIMMUNE HEPATITIS SPECIFIC ANTI-SMOOTH could detect TGRS in KC as demonstrated by co-localization with KC MUSCLE ANTIBODIES specific markers. Heneghan MA. Types of autoimmune hepatitis. Gregorio GV, Portmann B, Reid F, et al. Treatment is usually with steroids and other medicines which suppress inflammation. Table 2: Prevalence of commonly detected autoantibodies in autoimmune hepatitis. Viral serologies are negative. Autoimmune hepatitis is an uncommon cause of persistent liver inflammation (chronic hepatitis). If your body starts attacking itself, you may develop an autoimmune disorder. Read our disclaimer. Homberg JC, Abuaf N, Bernard O, et al. It predominantly affects women. AIH has an insidious onset in most patients and its presentation varies widely, ranging from asymptomatic disease to severe symptoms or even acute liver failure. She is started on prednisone. On exam, she is slightly jaundiced with scleral icterus and has hepatosplenomegaly. Background/Aim: Smooth muscle antibodies (SMA) characterize type 1 autoimmune hepatitis.Our aim was to evaluate sensitivity and specificity of different immunofluorescence substrates for the detection of SMA. Smooth muscle antibodies; TPMT, Thiopurine methyltransferase. These autoantibodies are considered as biomarkers of autoimmune hepatitis. Clinical Practice Guidelines. Actually, the incidence rate of AIH in Denmark has nearly doubled between 1994 to 2012, reaching a point prevalence in 2012 of 24/100,000 (35/100,000 for females) [13]. Wolf DC. Anti LKM-2 antibody is associated with drug induced hepatitis and LKM-3 antibody is associated with hepatitis D infection. It can occur at any age. A 24-year-old woman with a past medical history of vitiligo presents to the emergency room for abdominal pain. Antibodies are made to fight the pathogens. Thanked 3,374 Times in 907 Posts Reputation: 3384. Autoimmune hepatitis is an immune-mediated disorder characterised by hypergammaglobulinaemia, autoantibodies, and interface hepatitis. Anti LKM-2 antibody is associated with drug induced hepatitis and LKM-3 antibody is associated with hepatitis D infection. Autoimmune hepatitis is a chronic disease in which your body’s immune system attacks the liver and causes inflammation and liver damage. Elevated ANA levels are observed in various autoimmune diseases, especially in the diseases listed below. anti-glutamate decarboxylase. Paediatric AIH diagnosis is usually missed and patients present with decompensated liver disease. Lippincott Williams & Wilkins ; 2015 Kumar V, Abbas AK, Aster JC. The number of reported AIH cases is increasing in the developed countries but the same cannot be said about sub Saharan Africa (SSA). wegener's granulomatosis (proteinase-3) p-ANCA - peripheral . Laboratory results reveal a mild transaminitis and positive anti-mitochondrial antibodies but negative anti-nuclear antibody and anti-smooth-muscle antibodies. Since PSC and IBD are closely associated, it is not clear whether A-ANCA reactivity is more related to IBD or PSC. Thread Tools: Search this Thread: Display Modes #1 01-27-2012 bebix. Robbins & Cotran Pathologic Basis of Disease. In 1965, it became designated by Mackay et al. Elsevier Saunders ; 2015 Remy P. Hepatitis E. In: Anand BS, Hepatitis E. New York, NY: WebMD. + liver/kidney microsome type 1 antibody (antiLKM1), autoimmune chronic inflammation of the liver, diagnostic testing must rule out viral hepatitis, bridging or multilobular necrosis, inflammation, and fibrotic changes, positive serologies for hepatitis viruses, also presents with restrictive cardiomyopathy, darkening skin, joint pain, and pancreatic insufficiency, histology showing bridging necrosis or multilobular necrosis. Anti LKM-1 antibodies are associated with patients with type 2a and 2b autoimmune hepatitis. Autoimmune Hepatitis. high sensitivity; Anti-double stranded DNA (dsDNA) high specificity; helps monitor disease activity; Anti-Smith. Our aim was to evaluate sensitivity and specificity of different immunofluorescence substrates for the detection of SMA. Manns MP, Czaja AJ, Gorham JD, et al. autoimmune chronic inflammation of the liver. Elevation of serum IgG levels (hypergammaglobulinemia) and presence of autoimmune antibodies such as anti-nuclear antibodies (ANA), anti-smooth muscle antibodies (SMA), anti-soluble liver antigen (anti-SLA), and anti-liver/ kidney microsomal antibodies (anti-LKM)indicate autoimmune hepatitis. This activity reviews the pathophysiology, causes, presentation, and diagnosis of autoimmune hepatitis and highlights the role of the interprofessional team in its management. Our study highlights the clinical profile of … Autoimmune hepatitis (AIH) is a rare disease in which the body's immune system attacks the cells of the liver. Autoimmune hepatitis is an immune-mediated disorder characterised by hypergammaglobulinaemia, autoantibodies, and interface hepatitis. AIH prevalence and clinical … Type 2 autoimmune hepatitis presents with positive anti-liver/anti-kidney microsome (anti-LMK) type 1 antibodies or anti-liver cytosol (anti-LC) type 1 antibodies. I always confuse Primary Biliary Cirrhosis - … I always confuse Primary Biliary Cirrhosis - … Histology: ground-glass hepatocytes; nodular-appearing infiltrates; steatosis in hepatitis C virus genotype 3. Presence of hepatitis C serologic markers (hepatitis C antibody, hepatitis C viral RNA). Antibody detected on autoantibody screen. Hardtke-wolenski M, Fischer K, Noyan F, et al. urine metanephrine. Clinical presentation ranges from asymptomatic cases to patients that present with symptoms of acute liver failure (jaundice, right upper quadrant pain). Autoimmune Hepatitis is a disorder in which the body's own immune system mistakenly targets cells in the liver. The differential diagnoses listed here are not exhaustive. Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is an autoimmune disease of the liver. USMLE Forums Master : Steps History: 1+CK+CS+3. Autoimmune hepatitis is an uncommon cause of persistent liver inflammation (chronic hepatitis). Autoimmune Hepatitis (Liver Disease) Panel. The exact cause of autoimmune hepatitis is unclear, but genetic and enviromental factors appear to interact over time in triggering the disease.Untreated autoimmune hepatitis can lead to scarring of the liver (cirrhosis) and eventually to liver failure. Genetic predisposition and environmental danger signals initiate chronic autoimmune hepatitis driven by CD4+ T cells. Antibody tests also help pinpoint the type of autoimmune hepatitis you have. (A) Innate immunity, as adaptive immunity takes 1-2 weeks Hepatology 1997; 26:567. Diagnosis and Management of Autoimmune Hepatitis. Objectives To determine whether ANA, SMA and anti-SLA/LP help to accurately diagnose patients with AIH. + antinuclear antibodies (ANA) + smooth muscle antibodies (SMA) type 2 AIH. Clinical presentation varies and patients may be asymptomatic or even show signs of acute liver failure. … + liver/kidney microsome type 1 antibody (antiLKM1) + antimitochondrial antibody (AMA) Epidemiology. 1. Diagnosis and management of autoimmune hepatitis. Smooth muscle antibodies (SMA) characterize type 1 autoimmune hepatitis. Treatment is usually with steroids and other medicines which suppress inflammation. Assessment. Antinuclear antibodies (ANAs) Brief description. I always confuse Primary Biliary Cirrhosis - Antimitochondrial antibody with Autoimmune Hepatitis - Antismooth muscle antibody This is my way to remember this now: Primary Biliary Cirrhosis = MAMA The patient is old enough to be my mom M = Middle aged woman AMA = AntiMitochondrial Antibody How the Test is Performed A blood sample is needed. The antibody is useful in making a diagnosis of autoimmune hepatitis. In an individual living with an autoimmune disease, autoantibodies are produced and attack the body’s own tissue. Antineutrophil cytoplasmic antibodies with atypical perinuclear patterns (A-ANCA) are frequently found in inflammatory bowel diseases (IBD), particularly in ulcerative colitis, primary sclerosing cholangitis (PSC), and autoimmune hepatitis (AIH) (1,2). Autoimmune hepatitis (AIH) is a rare disease in which the body's immune system attacks the cells of the liver. Although the etiology is unclear, it is commonly associated with other autoimmune conditions (e.g., type 1 diabetes mellitus, celiac disease). Positivity for anti-nuclear (ANA) and/or anti-smooth muscle (SMA) autoantibodies defines AIH type 1 (AIH-1), whereas anti-liver kidney microsomal type 1 (anti-LKM1) and/o … Clinical significance of autoantibodies in autoimmune hepatitis J Autoimmun. Written and peer-reviewed by physicians—but use at your own risk. Autoimmune hepatitis (AIH) is a rare form of chronic hepatitis that predominantly affects women. Although most patients respond satisfactorily to steroid and thiopurine-based treatment regimens, up to 40% relapse and 10% … Choose from 45 different sets of antibodies usmle flashcards on Quizlet. In the T cell, the signal transduction complex is a multichain structure called CD3. [PMC free article] Whitehouse JM, Holborow EJ. This is the most common type of the disease. FINAL DIAGNOSIS: AUTOIMMUNE HEPATITIS, TYPE I. Clinical Practice Guidelines. as "autoimmune hepatitis" at an international meeting, at which the general concept of autoimmunity was endorsed by the scientific community. She has had abdominal pain intermittently for the past few weeks and has seen her primary care physician for this issue. The prognosis is favorable if patients are treated appropriately; without treatment, cirrhosis may develop. USMLE Forums Master : Steps History: 1+CK+CS+3. Antibodies will aid in the destruction of pathogen through opsonization, complement activation and antibody-dependent cellular cytotoxicity. An ASMA test looks for the one type of autoantibody that attacks smooth muscle. Posts: 1,357 Threads: 194. Clinical presentation ranges from asymptomatic cases to patients that present with symptoms of acute liver … The cause is not known. USMLE Step 2 CK Mnemonics Mnemonics, acronyms, reminders, and memorizing tips for the USMLE Step 2 CK. Without treatment, autoimmune hepatitis may get worse and lead to complications, such as cirrhosis and liver failure. The cause is not known. Autoimmune hepatitis is liver inflammation that occurs when your body's immune system turns against liver cells. We describe the occurrence of autoimmune hepatitis in a patient treated with adalimumab, a fully human IgG antibody against tumor necrosis factor, for psoriatic arthritis. Hepatitis B surface antibody (anti-HBs): The presence of anti-HBs is generally interpreted as indicating recovery and immunity from hepatitis B virus infection. Antibody detected on autoantibody screen. Background Autoimmune hepatitis (AIH) is a progressive inflammatory liver disease of unknown aetiology. Anti-HBs also develops in a person who has been successfully vaccinated against hepatitis B. About half the people with type 1 autoimmune hepatitis have other autoimmune disorders, such as celiac disease, rheumatoid arthritis or ulcerative colitis. Actually, the incidence rate of AIH in Denmark has nearly doubled between 1994 to 2012, reaching a point prevalence in 2012 of 24/100,000 (35/100,000 for females) [13]. Which of the following is most likely to cause a faster and stronger immunologic response against the same infectious agent after re-exposure? USMLE Step 2 CK Mnemonics Mnemonics, acronyms, reminders, and memorizing tips for the USMLE Step 2 CK. Autoantibody detection assists in the diagnosis and allows differentiation of autoimmune hepatitis (AIH) type 1 (AIH-1), characterized by antinuclear antibody (ANA) and/or smooth muscle antibody (SMA), and type 2 (AIH-2), distinguished by the presence of antibodies to liver-kidney microsome type 1 (anti-LKM1) and/or antibodies to liver cytosol type 1 (anti-LC1). Autoimmune hepatitis is a chronic. AIH prevalence and clinical … In: Post TW, ed. Blood tests include tests that check levels of the liver enzymes alanine transaminase (ALT) and aspartate transaminase (AST) and check for autoantibodies such as antinuclear antibody (ANA) and anti-smooth muscle antibody (SMA). It is characterised by the presence of circulating auto-antibodies with a high serum globulin concentration, inflammatory changes on liver histology, and a favourable response to immunosuppressive treatment. Anti-ASGPR antibody levels have also been reported to correlate with the inflammatory activity and therapeutic response (13). type 1 diabetes mellitus. Detection of atypical perinuclear antineutrophil … In: BS Anand. 1993 Oct; 18 (4):998–1005. Antismooth Muscle and Antiactin Antibodies Are Indirect Markers of Histological and Biochemical Activity of Autoimmune Hepatitis Claudia A. Couto,1,2 Paulo L. Bittencourt,3 Gilda Porta,4 Clarice P. Abrantes-Lemos,5 Flair J. Carrilho,6 Bianca D. Guardia,6 and Eduardo L.R. change in case ascertainment rates. The disease may start as acute hepatitis and progress to chronic liver disease and cirrhosis. Background Antinuclear antibodies (ANA), smooth muscle antibodies (SMA) and antibodies to a soluble liver antigen/liver pancreas (anti-SLA/LP) are useful markers that can help clinicians to diagnose and classify autoimmune hepatitis (AIH). Canc¸ado5,6 Reactivity and titers of autoantibodies vary during the course of autoimmune hepatitis associated with other autoimmune conditions, should be performed following the detection of AIH, Diagnosis is established based on positive. In addition, ANAs include autoantibodies against DNA and histones. Tests and procedures used to diagnose autoimmune hepatitis include: Blood tests. Clin Exp Immunol. CD21 is the receptor for EBV and CD81 is the receptor for hepatitis C and Plasmodium vivax. Although most patients respond satisfactorily to steroid and thiopurine-based treatment regimens, up to 40% relapse and 10% … Autoimmune hepatitis is a chronic. Autoimmune hepatitis: Treatment. Autoimmune hepatitis is a chronic, inflammatory disease of the liver that is characterized by circulating autoantibodies and elevated serum globulin levels. Diagnosis is established based on the detection of autoantibodies (especially anti-smooth muscle antibodies) and the histologic findings of liver biopsy. Type 1 is distinguished by the presence of anti-smooth muscle antibodies (ASMA) with or without anti-nuclear antibodies (ANA). Both need … Treatment of isolated rat KC with LPS leads to an increase in cytolcine … Hepatology 1997; 25:541. There are 2 primary types of Autoimmune Hepatitis. TSI stimulates thyroid production in Grave's. If left untreated, the inflammation causes 'scarring' of the liver (cirrhosis). Specialties. Antimitochondrial antibody. The B-cell co-receptor is implicated in the attachment of several infectious agents. ANAs are comprised of numerous antibodies against specific nuclear antigens. http://emedicine.medscape.com/article/172356, https://www.uptodate.com/contents/autoimmune-hepatitis-clinical-manifestations-and-diagnosis, http://www.aasld.org/sites/default/files/guideline_documents/autoimmunehepatitis2010.pdf, https://www.uptodate.com/contents/autoimmune-hepatitis-treatment. Background/Aim: Smooth muscle antibodies (SMA) characterize type 1 autoimmune hepatitis.Our aim was to evaluate sensitivity and specificity of different immunofluorescence substrates for the detection of SMA. Anti‐LKM1 antibodies stain the proximal renal tubules and the cytoplasm of hepatocytes. Subsequently, the disease was found to be associated with other autoimmune syndromes and was later termed "lupoid hepatitis" because of the presence of antinuclear antibodies. Type 2 autoimmune hepatitis – Type 2 AIH is defined by the presence of antibodies to liver/kidney microsomes (ALKM-1) and/or to a liver cytosol antigen (ALC-1), and, rarely, to ALKM-3 . AIH is subdivided according to antibody presence. Autoimmune Hepatitis is always a young woman, so..."the other one is the other one" :p This is too funny because whenever I see primary biliary cirrhosis I think of "anti-mom" - my mom's age range, and mitochondrial DNA is maternal, so Anti-mom = anti-mitochondrial :D The mainstay of treatment is non-specific immunosuppression, consisting of steroids with or without azathioprine. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Copyright © 2021 Lineage Medical, Inc. All rights reserved. This is the most common form of CAH in childhood and has a particularly poor prognosis and can be associated with hepatitis C infection. The way in which it does so, and the specific tissue it targets, varies depending on which autoimmune disease one lives with. Drug-Induced Autoimmune Hepatitis: Clinical Characteristics and Prognosis Einar Bjo¨rnsson,1,2 Jayant Talwalkar,2 Sombat Treeprasertsuk,2 Patrick S. Kamath,2 Naoki Takahashi,3 Schuyler Sanderson,4 Matthias Neuhauser,2 and Keith Lindor2 Drug-induced autoimmune hepatitis (DIAIH) has been reported to be caused by several drugs. They stain the cytoplasm of hepatocytes with a weakening of the stain around the central vein. Autoimmune hepatitis, formerly called lupoid hepatitis, is a chronic, autoimmune disease of the liver that occurs when the body's immune system attacks liver cells, causing the liver to be inflamed.Common initial symptoms include fatigue or muscle aches or signs of acute liver inflammation including fever, jaundice, and right upper quadrant abdominal pain.
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