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Autoimmune hepatitis — RCPSC IM MCQ

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HardGastroenterology/HepatologyAutoimmune hepatitisRCPSC IM

A 44-year-old woman has fatigue, arthralgia and jaundice. ALT is 1,120 U/L, bilirubin is 78 micromol/L, IgG is markedly elevated, and ANA and smooth muscle antibody are positive. Viral hepatitis serology is negative. Ultrasound shows a patent hepatic and portal venous system. What is the most likely diagnosis?

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Correct answer: E — Autoimmune hepatitis

Marked hepatocellular injury with high IgG, positive ANA and smooth muscle antibody, and exclusion of viral and vascular causes supports autoimmune hepatitis.

Reference: Canadian Association for the Study of the Liver autoimmune liver disease guidance