Autoimmune Hepatitis—Immunologically Triggered Liver Pathogenesis—Diagnostic and Therapeutic Strategies

Figure 3

Proposed treatment strategy for indeterminate acute severe hepatitis based on the authors’ experience. Patients with diagnosis of acute severe hepatitis receive early steroid treatment. Evaluation after 3 days is aimed at assessing a possible steroid response. If no response is seen, steroid therapy is stopped and alternative treatment strategies are considered. In case of therapy response, steroids are tapered accordingly. After steroid withdrawal, reevaluation may allow for discrimination between autoimmune hepatitis (AIH) and drug-induced liver injury (DILI), since early steroid tapering in AIH is commonly accompanied by a disease relapse.