There are many causes of inflammation of the liver (hepatitis); autoimmune hepatitis is due to a faulty immune system that attacks the body’s own cells. Without treatment, serious problems can develop, but the disease can be controlled with prompt diagnosis and medications.
What Causes Autoimmune Hepatitis?
Autoimmune diseases occur when a faulty signal causes the body’s immune system to attack its own tissues. In autoimmune hepatitis, the precise trigger is unclear, though a viral liver infection or genetic predisposition may be involved. Auto-antibodies produced by the immune system attack the cells of the liver, leading to inflammation that impairs the organ’s function.
Symptoms of Autoimmune Hepatitis
The symptoms of autoimmune hepatitis may develop slowly or more quickly, in which case the disease can resemble acute viral hepatitis. The most common symptoms are tiredness, loss of appetite and joint pain. Jaundice may occur in more advanced disease, and untreated autoimmune hepatitis may develop into liver cirrhosis.
People with autoimmune hepatitis often have other autoimmune diseases affecting parts of the body as diverse as the eyes, kidneys and skin. Autoimmune hepatitis may also be associated with type 1 diabetes.
How is Autoimmune Hepatitis Treated?
Liver biopsy, in which a small sample of tissue is taken for analysis, is the most important test for autoimmune hepatitis. Diagnosis can be helped by liver function tests for hepatitis, testing for auto-antibodies in the blood, and ultrasound scanning. When the disease has been confirmed, and the extent of the liver damage determined, drugs that suppress the immune system are prescribed to improve the symptoms and prevent further damage.
High doses of corticosteroids are generally given first; once the disease is under control, the dose can be lowered to minimize the side-effects of these powerful drugs. This treatment may be combined with another drug called azathioprine, which allows lower doses of corticosteroids to be used.
A liver transplant may be considered in the small proportion of cases that do not respond to medications, and in people with advanced disease that has progressed to liver cirrhosis.
Autoimmune Hepatitis Prognosis
The prognosis of autoimmune hepatitis depends on the response to immunosuppressive drugs and the severity of the disease when treatment is started. Most people with autoimmune hepatitis can live normal lives, if the disease is detected before severe liver damage occurs. Relapses are common, however, so it is important that patients have regular follow-up assessments.
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