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.