Autoimmune hepatitis: Indications for drug therapy

Serum aminotransferase levels greater than 10-fold the upper limit of normal

Serum aminotransferase levels greater than twice the upper limit of normal along with:

Symptoms
An elevated IgG level, even if less than twice the upper limit of normal
An elevated conjugated bilirubin level
Interface hepatitis on liver biopsy

Serum IgG greater than twice the upper limit of normal

Cirrhosis with any degree of inflammation on biopsy

Age <18 years

Histologic features of bridging necrosis or multiacinar necrosis*

This table summarizes the indications for drug therapy for patients with autoimmune hepatitis. This table is intended for use in conjunction with other UpToDate content. Refer to UpToDate's topic on treatment of autoimmune hepatitis for additional details.

IgG: immunoglobulin G.

* It is also reasonable to use drug therapy when histologic findings are limited to interface hepatitis, particularly if the patient is young (ie, age <50 years).

Graphic 141280 Version 1.0

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Autoimmune hepatitis: Indications for drug therapy