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Autoimmune hepatitis — RACP Paediatrics MCQ

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ModerateGIAutoimmune hepatitisRACP Paediatrics

A 14-year-old girl presents with a 6-month history of fatigue, intermittent jaundice, and joint pains. ALT is 800 U/L. Total IgG is 25 g/L (elevated). ANA is positive at 1:640. She has no risk factors for viral hepatitis. What is the most likely diagnosis and most appropriate investigation?

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Correct answer: C — Autoimmune hepatitis panel (ANA, SMA, LKM)

Elevated transaminases with raised IgG and positive ANA/SMA/LKM antibodies in a young female with no viral hepatitis risk factors is suggestive of autoimmune hepatitis (AIH). Liver biopsy confirming interface hepatitis supports the diagnosis. Treatment is with prednisolone and azathioprine. Untreated AIH progresses to cirrhosis.

Reference: RCH Melbourne – 2023 – Hepatitis CPG; RACP Paediatric Curriculum – GI