Autoimmune hepatitis (AIH) is a kind of immune-mediated chronic liver disease, and its specific pathogenesis has not yet been fully elucidated. In recent years, the International Autoimmune Hepatitis Expert Group has revised histology and autoantibody evaluation criteria for diagnosing AIH and has clarified the definition of treatment response. The current standard treatment regimen is still glucocorticoids and azathioprine, but novel biological agents offer new therapeutic options for patients with refractory AIH. This article reviews the new progress in the diagnosis and treatment of AIH and explores the current challenges and future research directions.

Autoimmune hepatitis (AIH) is a kind of immune-mediated chronic liver disease, and its specific pathogenesis has not yet been fully elucidated. In recent years, the International Autoimmune Hepatitis Expert Group has revised histology and autoantibody evaluation criteria for diagnosing AIH and has clarified the definition of treatment response. The current standard treatment regimen is still glucocorticoids and azathioprine, but novel biological agents offer new therapeutic options for patients with refractory AIH. This article reviews the new progress in the diagnosis and treatment of AIH and explores the current challenges and future research directions.

Background::The potential impact of pre-existing coronary artery stenosis (CAS) on acute pulmonary embolism (PE) episodes remains underexplored. This study aimed to investigate the association between pre-existing CAS and the elevation of high-sensitivity cardiac troponin I (hs-cTnI) levels in patients with PE.Methods::In this multicenter, prospective case-control study, 88 cases and 163 controls matched for age, sex, and study center were enrolled. Cases were patients with PE with elevated hs-cTnI. Controls were patients with PE with normal hs-cTnI. Coronary artery assessment utilized coronary computed tomographic angiography or invasive coronary angiography. CAS was defined as ≥50% stenosis of the lumen diameter in any coronary vessel >2.0 mm in diameter. Conditional logistic regression was used to evaluate the association between CAS and hs-cTnI elevation.Results::The percentage of CAS was higher in the case group compared to the control group (44.3% [39/88] vs. 30.1% [49/163]; P = 0.024). In multivariable conditional logistic regression model 1, CAS (adjusted odds ratio [OR], 2.680; 95% confidence interval [CI], 1.243–5.779), heart rate >75 beats/min (OR, 2.306; 95% CI, 1.056–5.036) and N-terminal pro-B type natriuretic peptide (NT-proBNP) >420 pg/mL (OR, 12.169; 95% CI, 4.792–30.900) were independently associated with elevated hs-cTnI. In model 2, right CAS (OR, 3.615; 95% CI, 1.467–8.909) and NT-proBNP >420 pg/mL (OR, 13.890; 95% CI, 5.288–36.484) were independently associated with elevated hs-cTnI. Conclusions::CAS was independently associated with myocardial injury in patients with PE. Vigilance towards CAS is warranted in patients with PE with elevated cardiac troponin levels.