skip to main content

Type 1 AIH — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

EasyGastroenterologyType 1 AIHRACP Adult Medicine

A 28-year-old woman presents with jaundice and fatigue. ALT is 800 U/L, ALP is 180 U/L, IgG 28 g/L. ANA is positive (1:640), anti-SMA positive. Liver biopsy shows interface hepatitis with dense plasma cell infiltrate. AMA is negative. MRCP shows normal bile ducts. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Type 1 autoimmune hepatitis

Markedly elevated ALT (hepatocellular pattern), elevated IgG, positive ANA and anti-SMA, interface hepatitis with plasma cells, negative AMA, and normal MRCP is classic type 1 AIH. The Paris criteria or revised IAIHG criteria support the diagnosis. Treatment: prednisolone induction plus azathioprine for maintenance. Response to immunosuppression is expected in >80%.

Reference: EASL – 2025 – AIH Guidelines; eTG Gastrointestinal 2024