Treatment of Autoimmune Hepatitis Presenting with Jaundice and Coagulation Disturbance

This protocol addresses the acute presentation of autoimmune hepatitis (AIH) in patients with clinically apparent jaundice and a coagulation disturbance (INR ≥1.5 and <2), who do not have hepatic encephalopathy and do not have acute liver failure or acute-on-chronic liver failure.

The combination of jaundice with a measurable but sub-severe coagulation disturbance defines this specific subgroup. The absence of encephalopathy and the absence of acute or acute-on-chronic liver failure are equally important distinguishing criteria that shape which management pathway applies.

An early treatment trial with a corticosteroid is the recommended approach for this presentation. The clinical goal is improvement of liver function within 3–7 days of treatment initiation. Dose selection, monitoring parameters, and the decision pathway if improvement is not observed are detailed in the full structured protocol.