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Autoimmune Hepatitis — RACP Paediatrics MCQ

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HardGastroenterologyAutoimmune HepatitisRACP Paediatrics

A 12-year-old girl presents with jaundice, fatigue, and raised transaminases (ALT 800 U/L). ANA is strongly positive at 1:640, anti-smooth muscle antibody is positive. IgG is elevated. Hepatitis viral serology is negative. What is the most likely diagnosis?

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Correct answer: E — Autoimmune hepatitis

Autoimmune hepatitis presents with elevated transaminases, positive autoantibodies (ANA, anti-SMA, anti-LKM1), elevated IgG, and interface hepatitis on biopsy. Type 1 (ANA/SMA positive) is more common in adolescent girls. Treatment includes prednisolone induction followed by azathioprine maintenance.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Autoimmune Hepatitis