Autoimmune chronic active hepatitis in postmenopausal women

We reviewed the clinical and histologic features, course and response to therapy of 18 postmenopausal women with autoimmune chronic active hepatitis (CAH). The presentation of these patients was similar to that of younger patients, except for the lower incidence of associated autoimmune disease. Nuclear antibodies (ANA) were associated with complications, while smooth muscle antibodies (SMA) correlated with an uncomplicated course. Steroid therapy appeared to have less benefit and greater risk in our patients than in studies of all ages. The applicability of results of previous trials demonstrating benefit of corticosteroid therapy for CAH to postmenopausal women is questioned.