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Autoimmune hepatitis

Lupoid hepatitis

 

Autoimmune hepatitis is inflammation of the liver. It occurs when immune cells mistake the liver's normal cells for harmful invaders and attack them.

Causes

 

This form of hepatitis is an autoimmune disease. The body's immune system cannot tell the difference between healthy body tissue and harmful, outside substances. The result is an immune response that destroys normal body tissues.

Liver inflammation, or hepatitis, may occur along with other autoimmune diseases. These include:

  • Graves disease
  • Inflammatory bowel disease
  • Rheumatoid arthritis
  • Scleroderma
  • Sjögren syndrome
  • Systemic lupus erythematosus
  • Thyroiditis
  • Type 1 diabetes
  • Ulcerative colitis

Autoimmune hepatitis may occur in family members of people with autoimmune diseases. There may be a genetic cause.

This disease is most common in young girls and women.

 

Symptoms

 

Symptoms may include:

  • Fatigue
  • General discomfort, uneasiness, or ill feeling (malaise)
  • Itching
  • Loss of appetite
  • Nausea or vomiting
  • Joint pain
  • Pale or clay-colored stools
  • Dark urine
  • Abdominal distention

Absence of menstruation (amenorrhea) may also be a symptom.

 

Exams and Tests

 

Tests for autoimmune hepatitis include the following blood tests:

  • Liver function tests
  • Anti-liver kidney microsome type 1 antibody (anti LKM-1)
  • Anti-nuclear antibody (ANA)
  • Anti-smooth muscle antibody (SMA)
  • Serum IgG
  • Liver biopsy to look for long-term hepatitis

 

Treatment

 

You may need prednisone or other corticosteroid medicines to help reduce the inflammation. Azathioprine and 6-mercaptopurine are drugs used to treat other autoimmune disorders. They have been shown to help people with autoimmune hepatitis, as well.

Some people may need a liver transplant.

 

Outlook (Prognosis)

 

The outcome varies. Corticosteroid medicines may slow the progress of the disease. However, autoimmune hepatitis may advance to cirrhosis. This would require a liver transplant.

 

Possible Complications

 

Complications may include:

  • Cirrhosis
  • Side effects from steroids and other medicines
  • Hepatocellular carcinoma
  • Liver failure

 

When to Contact a Medical Professional

 

Call your health care provider if you notice symptoms of autoimmune hepatitis.

 

Prevention

 

Autoimmune hepatitis cannot be prevented in most cases. Knowing the risk factors may help you detect and treat the disease early.

 

 

References

Czaja AJ. Autoimmune hepatitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 90.

Pawlotsky J-M. Chronic viral and autoimmune hepatitis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 149.

 
  • Digestive system

    Digestive system - illustration

    The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

    Digestive system

    illustration

  • Digestive system organs

    Digestive system organs - illustration

    The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.

    Digestive system organs

    illustration

    • Digestive system

      Digestive system - illustration

      The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

      Digestive system

      illustration

    • Digestive system organs

      Digestive system organs - illustration

      The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.

      Digestive system organs

      illustration

    A Closer Look

     

    Talking to your MD

     

      Self Care

       

      Tests for Autoimmune hepatitis

       

       

      Review Date: 8/20/2016

      Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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