INTRODUCTION
Autoimmune hepatitis (AIH) is a chronic disorder characterized by
continuing hepatocellular injury, which can progress to cirrhosis and
liver failure. The current prevalence of AIH is estimated to be 24 per
100,000. Generally, AIH is seropositive with presence of auto-antibodies
like antinuclear, anti-smooth muscle, anti-liver kidney microsomal
antibodies among many others. But sometimes there are no autoantibodies
detected in the serum when it is called seronegative AIH which presents
with a course similar to classic AIH. This makes it a particularly
challenging diagnosis that is made after excluding other causes of
hepatitis like medication induced, toxin induced or infectious
hepatitis. Seronegative AIH may be associated with other autoimmune
diseases like Graves’ disease concurrently.
In the United States, we see 1 in 200,000 cases occurring every year.
Since this a treatable cause of liver disease, the progression can be
stopped and even reversed with early institution of steroid therapy. The
disease can manifest with all the symptoms and complications of chronic
liver disease ranging from myalgia, nausea, vomiting to severe
complications like portal hypertension with caput medusae and esophageal
varices. Since this a treatable cause of liver disease, the progression
can be stopped and life- threatening complications can be prevented and
even reversed with early institution of steroid therapy.