Historical reflections on autoimmune hepatitis.

摘要: Autoimmune hepatitis (AIH), initially known as chronic active or (and by various other names), first came under clinical notice in the late 1940s. However, quite likely, (CAH) had been observed prior to this and was attributed a persistently destructive virus infection of liver. An earlier controversial) designation 1956 lupoid derived from associated L.E. cell test positivity emphasized accompanying multisystem features immunological aberrations. Young women featured prominently early descriptions CAH. AIH applied 1965 descriptive term. Disease-characteristic autoantibodies were defined 1960s, notably antinuclear antibody (ANA), smooth muscle (SMA) liver-kidney microsomal (LKM) antibody. These are still widely used diagnostically but their relationship pathogenesis is not evident. A liver disease specific autoantigen has long searched for unsuccessfully. Prolonged immunosuppressive therapy with predisolone azathioprine 1960s proved beneficial remains standard today. like many autoimmune diseases particular HLA alleles especially "ancestral" B8, DR3 haplotype, also DR4. Looking forwards, one several enigmatic that, despite being (relatively) organ specific, marked reactivities non-organ-specific autoantigens. New paradigms needed explain occurrence, expressions such diseases.