The Center is specialized at complicated liver diseases with a focus in autoimmune liver diseases and especially: Autoimmune Hepatitis (ΑIΗ) and Primary Biliary Cirrhosis (PBC). These are complex diseases requiring special and multifactorial approach in terms of diagnosis, follow-up and treatment.

2.1 AUTOIMMUNE HEPATITIS

Autoimmune Hepatitis is one of the causes of chronic hepatitis leading to liver cirrhosis if untreated. It is a relatively rare disease that affects both men and women of any age. It usually progresses silently, without symptoms. Diagnostic workup and follow-up includes: • Laboratory tests (aminotransferases, globulins and especially IgG) and autoantibody detection (antinuclear antibodies-ANA, anti-smooth muscle antibodies-SMA etc) • Liver biopsy, which is essential both for the diagnosis but also for excluding other causes of liver disease The type of treatment used is called immunosuppression and aims to suppress our immune system. It includes steroids and other immunosuppressive regimens (azathioprine or mycophenolate).

2.2 PRIMARY BILIARY CHOLANGITIS

Primary Biliary Cholangitis is a chronic liver disease characterized by the destruction of the small bile ducts of the liver (the tubes that connect the liver with the intestine). It is a progressive disease that could lead to cirrhosis, although progression to cirrhosis is rare nowadays providing that the disease is diagnosed timely. The disease affects mainly middle age women, although men and younger women can also be affected. The disease is frequently asymptomatic albeit some patients may exhibit permanent fatigue and generalized pruritus. Tests essential for the diagnosis and follow up include: • Measurement of serum alkaline phosphatase, IgM globulin and aminotransferases. Detection of antimitochondrial autoantibodies (AMA) is fundamental for the diagnosis • In some cases (not always) liver biopsy may be required The basic treatment is ursodeoxycholic acid (URSO or UDCA) that has been found to prevent disease progression.