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{{Autoimmune hepatitis}}
{{Autoimmune hepatitis}}
{{CMG}}; {{AE}}:{{MKK}}
{{CMG}}; {{AE}}:{{MKK}}
==Overview==
==Overview==
Patients with autoimmune hepatitis usually appear normal. Physical examination of patients with autoimmune hepatitis are [[jaundice]], [[hepatomegaly]], [[splenomegaly]], [[hepatic encephalopathy]] and [[Spider angiomata|spider angiomata.]]


==Physical Examination==
==Physical Examination==
*Physical examination of patients with Autoimmune hepatitis is usually remarkable for: Jaundice, Hepatomegaly, and Spider angiomata.
Physical examination of Autoimmune hepatitis patient  who progresses to cirrhosis:<ref name="pmid16394302">{{cite journal |vauthors=Krawitt EL |title=Autoimmune hepatitis |journal=N. Engl. J. Med. |volume=354 |issue=1 |pages=54–66 |year=2006 |pmid=16394302 |doi=10.1056/NEJMra050408 |url=}}</ref>
*[[Jaundice]]
*[[Hepatomegaly]]
*[[Spider angiomata]]
===Appearance of the Patient===
===Appearance of the Patient===
*Patients with Autoimmune hepatitis usually appear .  
*Patients with autoimmune hepatitis usually appear normal initially. If it progresses then patient appear weak due to constitutional symptoms such as [[weight loss]], [[anorexia]], and [[muscle atrophy]].
 
*Yellowish discoloration of the skin.
===Vital Signs===
*[[Abdominal distension]] may also be present due to [[ascites|ascites.]]
 
*Normal/low blood pressure with normal pulse pressure.
*High-grade / low-grade fever
*[[Hypothermia]] / hyperthermia may be present
*[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
*[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse
*Tachypnea / bradypnea
*Kussmal respirations may be present in _____ (advanced disease state)
*Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
*High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]]
 
===Skin===
===Skin===
*[[Jaundice]]
*[[Jaundice]]
*Spider angiomata
*[[Spider angioma|Spider angiomata]]<ref name="pmid10423070">{{cite journal |author=Li CP, Lee FY, Hwang SJ, ''et al'' |title=Spider angiomas in patients with liver cirrhosis: role of alcoholism and impaired liver function|journal=Scand. J. Gastroenterol. |volume=34 |issue=5 |pages=520-3 |year=1999 |pmid=10423070 |doi=}}</ref> 
<gallery widths=150px>
<gallery widths="250px">
 
<gallery widths="250px">
UploadedImage-01.jpg | Description {{dermref}}
File:Spider nevus.jpg|[[spider angiomata]] |Spider angiomata<ref>https://commons.wikimedia.org/wiki/File:Spider_nevus.jpg#/media/</ref>
UploadedImage-02.jpg | Description {{dermref}}
File:Cholangitis Jaundice.jpg|thumb|250px|Sclerotic jaundice in a female <ref>By Bobjgalindo - Own work, GFDL, https://commons.wikimedia.org/w/index.php?curid=10762793</ref>
 
</gallery>
</gallery>
===HEENT===
===HEENT===
*Hirsutism
*[[Hirsutism]]
*Icteric sclera
*[[Icteric sclera]]  
*Acne
*[[Acne]]
 
===Neck===
*[[Jugular venous distension]]
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
*[[Thyromegaly]] / thyroid nodules
*[[Hepatojugular reflux]]
 
===Abdomen===
===Abdomen===
*[[Abdominal distention]](Ascites)
*[[Abdominal distention]](Ascites)
*[[Hepatomegaly]]  
*[[Hepatomegaly]]  
*[[splenomegaly]]
*[[splenomegaly]]
 
*[[Caput medusae]]
===Neuromuscular===
===Neuromuscular===
*Patient present with hepatic encephalopathy
*[[Hepatic encephalopathy]] patient presents with:
*Patient is disoriented to persons, place, and time
**Altered mental status
*Altered mental status
**[[Confusion]]
**[[Coma]]


==References==
==References==

Latest revision as of 17:26, 9 January 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: :Manpreet Kaur, MD [2]

Overview

Patients with autoimmune hepatitis usually appear normal. Physical examination of patients with autoimmune hepatitis are jaundice, hepatomegaly, splenomegaly, hepatic encephalopathy and spider angiomata.

Physical Examination

Physical examination of Autoimmune hepatitis patient who progresses to cirrhosis:[1]

Appearance of the Patient

  • Patients with autoimmune hepatitis usually appear normal initially. If it progresses then patient appear weak due to constitutional symptoms such as weight loss, anorexia, and muscle atrophy.
  • Yellowish discoloration of the skin.
  • Abdominal distension may also be present due to ascites.
  • Normal/low blood pressure with normal pulse pressure.

Skin

HEENT

Abdomen

Neuromuscular

References

  1. Krawitt EL (2006). "Autoimmune hepatitis". N. Engl. J. Med. 354 (1): 54–66. doi:10.1056/NEJMra050408. PMID 16394302.
  2. Li CP, Lee FY, Hwang SJ; et al. (1999). "Spider angiomas in patients with liver cirrhosis: role of alcoholism and impaired liver function". Scand. J. Gastroenterol. 34 (5): 520–3. PMID 10423070.
  3. https://commons.wikimedia.org/wiki/File:Spider_nevus.jpg#/media/
  4. By Bobjgalindo - Own work, GFDL, https://commons.wikimedia.org/w/index.php?curid=10762793

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