A young female patient presents with jaundice and elevated liver enzymes. She has a history of two smilar episodes in the past. Her serum ANA was 1:40 and IgG was 2400 IU. Her serum copper levels were normal and viral markers were negative. A liver biopsy was carried out and based on the pathology repo, you treated her with immunosuppressants and the patient's condition improved. What was the most likely finding on pathology repo to suggest the treatment?
Non-alcoholic steatohepatitis
Hemosiderosis
Autoimmune hepatitis
Primary biliary cirrhosis
Ans. c. Autoimmune hepatitisMany of the clinicalfeatures of autoimmune hepatitis are similar to those described for chronic viral hepatitiso.. Fatigue, malaise, anorexia, amenorrhea, acne, ahralgias, and jaundice are commono.. Occasionally ahritis, maculopapular eruptions (including cutaneous vasculitis), erythema nodosum' colitis'pleurisy pericarditis, anemia, azotemiao and sicca syndromeType I autoimmune hepatitis- Associated with marked hyperglobulinemia, lupoid features, circulating ANAsa' andHLA-DR3 or HLA-DR4 (especially BB-DRB1-03).Associated autoantibodies: Autoantibodies against actin as well as atypical pANCAType ll autoimmune hepatitis- Linked to HLA-DRB1 and HLA-DQBI haplotypesAssociated with anti-LKMIType lll autoimmune hepatitis- These patients lack ANA and anti-LKMI but have circulating antibodies to solubleliver antigen/liver pancreas antigen