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Autoimmune hepatitis — RCPSC IM MCQ

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HardGastroenterology/HepatologyAutoimmune hepatitisRCPSC IM

A 37-year-old has autoimmune hepatitis with jaundice, ALT 980 U/L, elevated IgG and interface hepatitis. Viral hepatitis and biliary obstruction have been excluded. What is the best initial treatment?

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Correct answer: E — Start glucocorticoid-based induction and add azathioprine when indicated

The best answer is “Start glucocorticoid-based induction and add azathioprine when indicated”. Active autoimmune hepatitis warrants immunosuppressive induction, commonly glucocorticoid with later or concurrent azathioprine according to severity and contraindications. The alternatives treat different liver diseases or permit progressive injury. Baseline blood counts, liver tests and thiopurine suitability guide combination therapy, while response and treatment toxicity require structured monitoring.

Reference: Canadian Association for the Study of the Liver: https://hepatology.ca/