INTRODUCTION
Autoimmune hepatitis (AIH) is a group of diseases characterized by
necro-inflammatory liver damage, the presence of specific
autoantibodies, elevated γ-globulin and high sensitivity to
corticosteroid therapy. Although epidemiological data are limited, the
prevalence of AIH ranges from 11 to 17 per 100,000 population with a
north-south gradient.1, 2 This disease is rarely
reported in sub-Saharan Africa.1, 3 She’s probably
underdiagnosed. The diagnosis of AIH is based on criteria updated by the
International Autoimmune Hepatitis Group (IAHG) in
1999.2, 3 Despite the presence of these criteria,
diagnosis remains difficult, especially in low-income
countries.1 Because the investigations are expensive
to rule out other diseases that may resemble it. In addition, liver
biopsy remains unavailable in some countries. Treatment is based on
corticosteroid therapy followed by an
immunomodulator.4, 5, 6 In Madagascar, no case has yet
been described on the AIH. We report two cases of autoimmune hepatitis
diagnosed and followed up in a department of Gastroenterology,
University Hospital Joseph Raseta Befelatanana, Antananarivo,
Madagascar. We will discuss the diagnostic difficulties compared to the
investigations available and the treatment compared to that currently
recommended.