自身免疫性胰腺炎0.pdfVIP

T h e n e w e ng l a nd j o u r na l o f m e dic i n e review article medical progress Autoimmune Hepatitis Edward L. Krawitt, M.D. From the Department of Medicine, Uni- utoimmune hepatitis is a generally progressive, chronic hep- versity of Vermont, Burlington; and the atitis of unknown cause that occurs in children and adults of all ages. Oc- Department of Medicine, Dartmouth Col- Acasionally, it has a fluctuating course, with periods of increased or de- lege, Hanover, N.H. Address reprint re- quests to Dr. Krawitt at the University of creased activity. The diagnosis is based on histologic abnormalities, characteristic Vermont, Given C-246, Burlington, VT clinical and biochemical findings, and abnormal levels of serum globulins, includ- 05405-0068, or at edward.krawitt@uvm. edu. ing autoantibodies. Since the first descriptions of this disorder more than 50 years 1 ago, many labels have been applied, but “autoimmune hepatitis” has been accepted N Engl J Med 2006;354:54-66. as the most appropriate and least redundant term.2,3 Variant, overlapping, or mixed Copyright © 2006 Massachusetts Medical Society. forms of autoimmune hepatitis that share features with other putative autoimmune liver diseases, primary biliary cirrhosis, and primary sclerosing cholangitis occur as well. The distinctions among these di