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home - Liver - Autoimmune Conditions - Autoimmune Hepatitis Treatment Written by Dr Sebastian Zeki
Knowledge


Recognises and appropriately investigates patients with auto-immune
liver diseases

Aware of management and complications of autoimmune liver
disease including extra-hepatic manifestations and associations
including malignant complications in PSC

Skills
Appreciates and understands that this range of liver disease is
frequently under-diagnosed and may have been inappropriately
managed

Selects appropriate immunomodulatory therapy has awareness of
side effects and may well require specialist care

Behaviours
Responds urgently to the management challenge of these severe and
often acute diseases and involves more specialist services where
required

Autoimmune Hepatitis Treatment

Criteria for Combination Regime:Preferred by patient.Postmenopausal patient.Obesity.Osteopoenia.DM/ HTN.Long term treatment needed. Written by Dr Sebastian Zeki Relative Indicators For Treatment:Persistent symptoms.Disease progression.Mild- mod changes. Treatment of Autoimmune hepati- Criteria for Prednisolone Only:Severe cytopoenia.TPMT deficiency.Active neoplasia.Short term trial. Absolute Indicators For Treatment:AST > 10 fold normal.AST > 5 fold normal and gammaglob > 2 fold normal.Histological findings.Incapactitating symptoms. Liver trans-plantation No benefitBetter but ster-oid dependence 65% Deterioration Sustained remissionIndefinate therapy 20% Improvement80% Active Disease 65% Remission13 % Drug toxicity13% Incomplete response9% Treatment failure Response to Treament90% of patients show decrease bilirubin/ AST/ gammaglob in 2 weeks.If no remission in 2 years- 43% decompensate.If no remission in 4 years 63% decompensate.

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