Refractory autoimmune hepatitis in children: Considerations for assessment and management

Figure 2 Histopathology of autoimmune hepatitis in a 13-year-old patient with good compliance on azathioprine but with mildly elevated aminotransferases (55-70 IU/L; upper limit of normal 40 IU/L) and immunoglobulin G (17 g/L; upper limit of normal 16 g/L). A and B: Classical features of autoimmune hepatitis in the index biopsy showing lymphoplasmacytic infiltrate affecting both portal and perivenular regions; C: Interface hepatitis with emperipolesis and hepatocyte resetting. Hematoxylin-eosin original magnifications, × 100, × 200, × 200; D and E: Follow-up biopsy demonstrating ongoing portal infiltrate with an interface component; F: Resolution of acute necro-inflammatory and perivenular inflammation, leaving bridging fibrosis. Hematoxylin-eosin original magnifications × 100, × 100, Haematoxylin van Gieson × 40.