Autoimmune Hepatitis
Autoimmune hepatitis is a condition where the body’s immune system mistakenly attacks the liver, leading to inflammation. It is a chronic disease that can persist for many years, and if left untreated, it can result in liver cirrhosis and failure.
There are two forms of this disease. Type 1, also known as classic autoimmune hepatitis, is more common and primarily affects young women. It is often associated with other autoimmune disorders. Type 2 autoimmune hepatitis, on the other hand, is less common and typically affects girls between the ages of 2 and 14.
Important Facts to Know
Autoimmune Hepatitis is a serious condition that can worsen over time if not treated.
It can lead to cirrhosis and liver failure.
Autoimmune Hepatitis is a rare disorder that affects females four times more frequently than males.
People with other autoimmune conditions have a 25-50% chance of developing autoimmune hepatitis, putting them at a higher risk.
Information for the Newly Diagnosed
What causes autoimmune hepatitis? Normally, the immune system defends the body against foreign invaders such as bacteria and viruses. However, in autoimmune hepatitis, the immune system mistakenly attacks the liver cells, causing long-term inflammation and damage. The exact reasons behind this self-attack are still unknown, although hereditary and prior infections may play a role.
What are the symptoms and complications of autoimmune hepatitis?
- The symptoms of autoimmune hepatitis are often mild, but they can vary. Fatigue, abdominal discomfort, joint pain, itching, jaundice (yellowing of the skin and eyes), enlarged liver, nausea, and spider angiomas (visible blood vessels on the skin) are the most common symptoms. Other possible symptoms include dark urine, loss of appetite, pale stools, and absence of menstruation. Severe complications may include ascites (fluid accumulation in the abdomen) and mental confusion. In some cases (10%-20%), autoimmune hepatitis may present with symptoms resembling acute hepatitis.
How is autoimmune hepatitis diagnosed?
- Autoimmune hepatitis can develop suddenly. Initially, it may feel like a mild case of the flu. To confirm a diagnosis, your doctor will conduct blood tests and perform a liver biopsy. During the biopsy, a small sample of liver tissue is taken for examination in a laboratory.
How is autoimmune hepatitis treated?
- The primary goal of treatment is to suppress the immune system and prevent it from attacking the liver. This is achieved through the use of a medication called prednisone, which belongs to the steroid family. In some cases, a second medication called azathioprine (Imuran) may also be prescribed. Treatment usually starts with a high dose of prednisone, which is then gradually reduced as symptoms improve. Most patients require long-term medication, as autoimmune hepatitis can be controlled but not cured. It’s important to note that long-term use of steroids may cause side effects such as diabetes, osteoporosis, high blood pressure, glaucoma, weight gain, and increased susceptibility to infections. Additional medications may be necessary to manage these side effects.
Who is at risk for autoimmune hepatitis?
- Approximately 70% of individuals with autoimmune hepatitis are women, typically between the ages of 15 and 40. Many people with this condition also have other autoimmune diseases, including type 1 diabetes, thyroiditis (inflammation of the thyroid gland), ulcerative colitis (inflammation of the colon), vitiligo (patchy loss of skin pigmentation), or Sjogren’s syndrome (dry eyes and mouth).
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Questions to Ask Your Doctor
- Are my current symptoms, such as fatigue and lethargy, related to AIH?
- Which type of autoimmune hepatitis do I have? Type 1 or Type 2?
- What is the current status of my liver?
- Is there any liver damage?
- Will a liver transplant be necessary?
- Can I have AIH along with other autoimmune diseases?
- Will autoantibody blood tests be performed?
- Do I need a liver biopsy?
- What are the possible medications to treat AIH?
- If I respond well to therapy, will the dosage be gradually reduced over time?
- Will there be regular imaging/screening to detect other liver diseases like liver cancer?
- Will I require booster vaccines for Hepatitis A and Hepatitis B?