Autoimmune Hepatitis

Definition

Definition of Autoimmune Hepatitis
Autoimmune hepatitis is a disease in which the body's immune system attacks liver cells. This immune response causes inflammation of the liver, also called hepatitis. Researchers think a genetic factor may make some people more susceptible to autoimmune diseases. About 70 percent of those with autoimmune hepatitis are female.

The disease is usually quite serious and, if not treated, gets worse over time. Autoimmune hepatitis is typically chronic, meaning it can last for years, and can lead to cirrhosis-scarring and hardening-of the liver. Eventually, liver failure can result.

Symptoms

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

1. an enlarged liver
2. jaundice
3. itching
4. skin rashes
5. joint pain
6. abdominal discomfort
7. spider angiomas, or abnormal blood vessels, on the skin
8. nausea
9. vomiting
10. loss of appetite
11. dark urine
12. pale or gray-colored stools

Causes

Causes of Autoimmune Hepatitis
Autoimmune hepatitis occurs when the body's immune system, which ordinarily attacks viruses, bacteria and other pathogens, instead targets the liver. This attack on your liver can lead to chronic inflammation and serious damage to liver cells. Just why the body turns against itself is unclear, but researchers think autoimmune hepatitis could be caused by an interaction between several risk factors, such as infections, medications and a genetic predisposition.

Diagnosis

Diagnosis of Autoimmune Hepatitis
The doctor will make a diagnosis based on symptoms, blood tests, and a liver biopsy.

1. 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. Antibodies are proteins made by the immune system to fight off bacteria and viruses. Autoantibodies attack the body's cells. In autoimmune hepatitis, the immune system makes one or more types of autoantibodies. The most common are antinuclear antibodies (ANA), smooth muscle antibodies (SMA), and antibodies to liver and kidney microsomes (anti-LKM). People with type 1 have ANA, SMA, or both, and people with type 2 have anti-LKM. Blood tests also help distinguish autoimmune hepatitis from other diseases that resemble it, such as viral hepatitis B or C or a metabolic disease such as Wilson disease.
2. Liver biopsy: A tiny sample of liver tissue, examined with a microscope, can help doctors accurately diagnose autoimmune hepatitis and tell how serious it is. This procedure is done in a hospital or outpatient surgical facility.

Treatment

Treatment of Autoimmune Hepatitis
Treatment is with glucocorticoids with or without azathioprine and remission can be achieved in up to 60–80% of cases, although many will eventually experience a relapse. Patients who do not respond to glucocorticoids and azathioprine may be given other immunosuppressives like cyclosporin, tacrolimus, methotrexate etc. Liver transplantation may be required if patients do not respond to drug therapy or when patients present with fulminant liver failure.

Prognosis

Prognosis of Autoimmune Hepatitis
The outcome varies. Corticosteroid therapy may slow the disease progression. However, autoimmune hepatitis may worsen to cirrhosis and require a liver transplant.

Prevention

Prevention of Autoimmune Hepatitis
Autoimmune hepatitis is usually not preventable. Awareness of risk factors may allow early detection and treatment.