Abstract

CACERES-DELGADO, Laura Camila; ORTIZ-HENAO, Jesús Andrés; DELGADO-GALEANO, Mayut  and  GOMEZ-AYALA, Jaime Alberto. Response to immunomodulator treatment as diagnostic criterion of cirrhosis due to autoimmune hepatitis in a Colombian adult. Med. interna Méx. [online]. 2019, vol.35, n.3, pp.460-470.  Epub Mar 05, 2021. ISSN 0186-4866.  https://doi.org/10.24245/mim.v35i3.2381.

Autoimmune hepatitis is a progressive inflammatory disease that directly attacks the hepatocytes, in the long term and without timely treatment leads to cirrhosis. Worldwide, it is estimated between 11.6-35.9 cases/100,000 inhabitants, therefore, in medical practice it is low considered in the diagnosis of chronic hepatitis; because the simplified diagnostic criteria for this disease are complex, insofar as they focus on costly diagnostic means, and in lowand middle-income countries, it makes difficult the access, the opportunity for diagnosis and treatment. In addition, it is important to consider the sensitivity of these diagnostic means. This paper reports the clinical case of an adult woman with clinical features of cirrhosis due to autoimmune hepatitis, in which the use of recommended diagnostic methods did not directly favor the diagnosis of autoimmune disease. This clinical case is atypical, highlighting the clinical improvement with immunosuppressive treatment, considered a single diagnostic criterion of the classical criteria of 1999 to determine the diagnosis of autoimmune hepatitis, due to the high sensitivity of the response to the treatment evidenced at 48 hours. It is important to consider the initiation of immunosuppressive treatment of hepatitis autoinmunitaria, once the main causes of chronic liver disease have been ruled out, despite not meeting the diagnostic criteria, thus slowing the progression of the disease and a fatal outcome in the patient.

Keywords : Autoimmune hepatitis; Liver cirrhosis; Antibodies; Antinuclear.