It may rapidly progress to cirrhosis. Variations Thirteen per cent of patients have the clinical and histological disease but lack immunoserologic markers. These cases are classified as cryptogenic chronic hepatitis or autoantibody-negative autoimmune hepatitis . They are indistinguishable from type 1 autoimmune hepatitis and respond well to steroid therapy. The vulnerable area affected by autoimmune hepatitis is the periportal region.
Connective tissue replaces the lost parenchyma.
Periportal necrosis and fibrosis may extend far rom the portal region and link with an adjacent portal tract forming a bridging necrosis. Cirrhosis may follow. This process is similar to any other chronic active hepatitis. Only the presence of an excessive number of plasma cells and the rosetting phenomenon may indicate an autoimmune process, but their scarcity or absence do not rule out this condition. The histological form of lobular hepatitis especially in relapses is a distinguishing finding from viral hepatitis Fig.