Autoimmune hepatitis

Overview – Autoimmune hepatitis is a chronic inflammatory disease of the liver that occurs when the body’s immune system turns against the liver cells.

The exact cause of autoimmune hepatitis is not known but a combination of genetic and environmental factors appear to interact over time in triggering the disease.

The factors that may increase the risk of autoimmune hepatitis are being female; a history of certain infections such as measles, herpes simplex or Epstein-Barr virus; heredity; having an autoimmune disease, such as celiac disease, rheumatoid arthritis or hyperthyroidism (Graves’ disease or Hashimoto’s thyroiditis).

There are two main forms of autoimmune hepatitis.

Autoimmune hepatitis type 1 is the most common type that occurs at any age and half of these people have other autoimmune conditions such as celiac disease, rheumatoid arthritis or ulcerative colitis.

Autoimmune hepatitis type 2 is common in children and young people. Other autoimmune diseases may accompany this type of autoimmune hepatitis.

 

Symptoms

  • Symptoms vary in each individual with the disease. It may present as either an acute or chronic disease with a fluctuating pattern. Some people have few to none, whereas others experience signs and symptoms that may include
  • Jaundice (yellowing of the skin and whites of the eyes)
  • Abdominal discomfort
  • Fatigue
  • Weight loss
  • Skin rashes
  • Joint pain
  • Loss of menstrual periods

 

Complications

  • Liver cirrhosis can happen in people who are untreated. Cirrhosis is permanent scarring of the liver tissue.
  • Liver cirrhosis can cause esophageal varices. Esophageal varices are enlarged veins in the esophagus
  • Liver cirrhosis can also cause ascites. Ascites is fluid accumulation in the abdomen which can be uncomfortable and may interfere with breathing.
  • Liver failure as a result of extensive damage to the liver because of cirrhosis.
  • People with liver cirrhosis have an increased risk of liver cancer.

 

Diagnosis

  • Blood tests are done to measure liver enzymes, serum globulins, and serologic markers. The antibodies in the blood can distinguish autoimmune hepatitis from viral hepatitis and other conditions with similar symptoms.
  • A liver biopsy may be done to confirm the diagnosis and help guide treatment.

 

Lifestyle management

  • Follow a healthy diet and exercise program as recommended by your doctor.
  • Keep all the appointments with your doctor. Your doctor may check you regularly for the progression and complications of the disease.
  • People with long-term glucocorticoid therapy should include a regular weight-bearing exercise program, supplementation with vitamin D and calcium. Talk to your doctor about this if you are on glucocorticoid treatment.

 

Medical management

  • The treatment of autoimmune hepatitis is aimed to slow or stop the immune system attack on your liver. Prednisone, azathioprine are some of the medications used for autoimmune hepatitis.
  • Liver transplant is recommended when medications do not halt the progression of the disease, or if there is liver cirrhosis, liver failure.

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