Autoimmune Hepatitis
Discover this section to learn more about autoimmune hepatitis, including its description and diagnostic methods.
What is autoimmune hepatitis?
Autoimmune hepatitis is a condition in which the body’s immune system attacks the liver, leading to inflammation. This disease is chronic, meaning it persists for many years. If not treated, it can progress to cirrhosis and liver failure. There are two main forms of this disease:
Type 1, also known as classic autoimmune hepatitis, is the more common variant. It primarily affects young women and is often linked with other autoimmune diseases.
Type 2 autoimmune hepatitis is less common and typically affects girls between the ages of 2 and 14.
What causes autoimmune hepatitis?
The immune system is designed to protect the body by attacking bacteria, viruses, and other invading organisms. However, it should not target the body's own cells. When the immune system mistakenly does this, it results in a condition known as autoimmunity. In the case of autoimmune hepatitis, the immune system attacks liver cells, leading to chronic inflammation and damage to the liver. Although scientists are still investigating why the body turns against itself in this way, factors such as genetics and previous infections may play a role.
What are the symptoms and complications of autoimmune hepatitis?
Autoimmune hepatitis often begins with mild symptoms. When symptoms do occur, the most common ones include fatigue, abdominal discomfort, joint pain, itching, jaundice (yellowing of the skin and whites of the eyes), an enlarged liver, nausea, and spider angiomas (small blood vessels) on the skin. Other possible symptoms may include dark urine, loss of appetite, pale stools, and missed menstrual periods. More severe complications can involve ascites (fluid accumulation in the abdomen) and mental confusion. In 10% to 20% of cases, autoimmune hepatitis can present with symptoms similar to those of acute hepatitis.
How is autoimmune hepatitis diagnosed?
Autoimmune hepatitis can appear suddenly and may initially feel like a mild case of the flu. To diagnose this condition, your doctor will conduct blood tests and may suggest a liver biopsy. In a liver biopsy, a small sample of liver tissue is taken with a needle and examined in a laboratory.
How is autoimmune hepatitis treated?
The goal of treatment is to prevent the body’s immune system from attacking itself. This is achieved using a medication called prednisone, which is a type of steroid. Often, a second medication, azathioprine (Imuran), is also included in the treatment plan.
Treatment typically starts with a high dose of prednisone. As symptoms improve, the dosage is gradually reduced, and azathioprine may be added to the regimen. In most cases, autoimmune hepatitis can be managed but not cured, meaning that many patients will need to remain on medication for years, and sometimes for life.
Unfortunately, prolonged use of steroids can lead to serious side effects, such as diabetes, osteoporosis, high blood pressure, glaucoma, weight gain, and decreased resistance to infections. Additional medications may be necessary to help manage these side effects.se side effects.
Who is at risk for autoimmune hepatitis?
Approximately 70 percent of individuals with autoimmune hepatitis are women, typically between the ages of 15 and 40. Many people with this condition also experience other autoimmune diseases, such as type 1 diabetes, thyroiditis (inflammation of the thyroid gland), ulcerative colitis (inflammation of the colon), vitiligo (patchy loss of skin pigmentation), and Sjögren’s syndrome (characterized by dry eyes and dry mouth).