• Michael A Heneghan, Andrew D Yeoman, Sumita Verma, Alastair D Smith, and Maria Serena Longhi.
• Institute of Liver Studies, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK. Electronic address: michael.heneghan@nhs.net.
• Lancet. 2013 Oct 26; 382 (9902): 1433-44.

AbstractAutoimmune hepatitis is a disease of the hepatic parenchyma that can present in acute or chronic forms. In common with many autoimmune diseases, autoimmune hepatitis is associated with non-organ-specific antibodies in the context of hepatic autoimmunity. This dichotomy has made definition of a unifying hypothesis in the pathophysiology of the disease difficult, although data from the past 8 years have drawn attention to the role of regulatory T cells. Several triggers have been identified, and the disease arises in genetically susceptible individuals. Clinical and biochemical remission is achievable in up to 85% of cases. For the remaining patients, alternative immunosuppression strategies are an option. Liver transplantation provides an excellent outcome for patients with acute liver failure or complications of end-stage liver disease, including hepatocellular carcinoma. Variant or overlapping syndromes are worthy of consideration when unexpected disease features arise. Copyright © 2013 Elsevier Ltd. All rights reserved.

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