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About Autoimmune Hepatitis 

Autoimmune hepatitis is a disease in which the body's immune system attacks liver cells. This causes the liver to become inflamed (hepatitis). Researchers think a genetic factor may predispose some people to autoimmune diseases.

The disease is usually quite serious and, if not treated, gets worse over time. It's usually chronic, meaning it can last for years, and can lead to cirrhosis (scarring and hardening) of the liver and eventually liver failure.

Causes 

One job of the immune system is to protect the body from viruses, bacteria, and other living organisms. Usually, the immune system does not react against the body's own cells. However, sometimes it mistakenly attacks the cells it is supposed to protect.

This response is called autoimmunity. Researchers speculate that certain bacteria, viruses, toxins, and drugs trigger an autoimmune response in people who are genetically susceptible

Symptoms

Fatigue is probably the most common symptom of autoimmune hepatitis. Other symptoms include:

  • enlarged liver

  • jaundice

  • itching

  • skin rashes

  • joint pain

  • abdominal discomfort

  • fatigue  
  • spider angiomas (abnormal blood vessels) on the skin

  • nausea

  • vomiting

  • loss of appetite

  • dark urine

  • pale or gray colored stools 

People in advanced stages of the disease are more likely to have symptoms such as fluid in the abdomen (ascites) or mental confusion. Women may stop having menstrual periods.

Diagnosis

Your doctor will make a diagnosis based on your symptoms, blood tests, and liver biopsy.

  • Blood tests. A routine blood test for liver enzymes can help reveal a pattern typical of hepatitis, but further tests, especially for autoantibodies, are needed to diagnose autoimmune hepatitis.

  • Liver biopsy. A tiny sample of your liver tissue, examined under a microscope, can help your doctor accurately diagnose autoimmune hepatitis and tell how serious it is.

Treatment

Treatment works best when autoimmune hepatitis is diagnosed early. With proper treatment, autoimmune hepatitis can usually be controlled. In fact, recent studies show that sustained response to treatment not only stops the disease from getting worse, but also may actually reverse some of the damage.

The primary treatment is medicine to suppress (slow down) an overactive immune system.

Both types of autoimmune hepatitis are treated with daily doses of a corticosteroid called prednisone. Your doctor may start you on a high dose (20 to 60 mg per day) and lower the dose to 5 to 15 mg/day as the disease is controlled. The goal is to find the lowest possible dose that will control your disease.

Another medicine, azathioprine (Imuran) is also used to treat autoimmune hepatitis. Like prednisone, azathioprine suppresses the immune system, but in a different way. It helps lower the dose of prednisone needed, thereby reducing its side effects. Your doctor may prescribe azathioprine, in addition to prednisone, once your disease is under control.

Summary

  • Autoimmune hepatitis is a long-term disease in which your body's immune system attacks liver cells.

  • The disease is diagnosed using various blood tests and a liver biopsy.

  • With proper treatment, autoimmune hepatitis can usually be controlled. The main treatment is medicine that suppresses the body's overactive immune system.

Reference for Autoimmune Hepatitis Article

  • National Institutes of Health   

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