- Hx autoimmune dz: IBD, RA, thyroiditis, celiac dz, DM1
- Children > Adults
- Presentation can be acute, sub-acute, or chronic; smoldering to fulminant; can wax/wane
- Sx can include: fatigue, n, v, anorexia, itching, abdominal pain, small joint arthralgias
- Finding can range from none to hepatomegaly, splenomegaly, jaundice, edema
- Elevated transaminases; also elevated alk phos, T Bili (if sig cholestasis)
- + ANA; +Smooth Muscle Ab