Autoimmune hepatitis - symptoms, treatment, prognosis

 Autoimmune hepatitis is a chronic disease in which the body's immune system attacks the liver and causes inflammation and liver damage

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. The exact cause of autoimmune hepatitis is unknown, but it is thought to be a combination of genetic and environmental factors

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. Certain risk factors for developing autoimmune hepatitis have been identified, including a family history of autoimmune hepatitis, a history of bacterial or viral infections, being a cisgender female, or being assigned female at birth, and using certain medications

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Types of Autoimmune Hepatitis

There are two types of autoimmune hepatitis

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• Type 1: This is the most common type in the United States, accounting for 96% of autoimmune hepatitis cases in adults and about 90% of cases in children. It is characterized by the presence of anti-smooth muscle antibodies (ASMA) with or without anti-nuclear antibodies (ANA).
• Type 2: This type is uncommon in the United States but more frequently described in Europe. It accounts for 9-12% of autoimmune hepatitis cases in US children, as opposed to 38% of cases in children in the United Kingdom. Type 2 autoimmune hepatitis presents with positive anti-liver/anti-kidney microsome (anti-LMK) type 1 antibodies or anti-liver cytosol (anti-LC) type 1 antibodies.

Symptoms

Symptoms of autoimmune hepatitis can range from mild to severe, and some people with autoimmune hepatitis have no symptoms

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. Common symptoms include:

• Feeling tired
• Joint pain
• Nausea
• Poor appetite
• Pain over the liver, in the upper part of the abdomen
• Yellowish color of the whites of the eyes and skin, called jaundice
• Darkening of the color of urine
• Lightening of the color of stools
• Skin conditions, such as rash, psoriasis, vitiligo, or acne

Diagnosis

Diagnosis of autoimmune hepatitis is based on a combination of information from medical history, a physical exam, blood tests, imaging tests, and liver biopsy

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. No single test can diagnose autoimmune hepatitis. In most cases, doctors order a combination of tests, including a liver biopsy, to make a diagnosis.

Treatment

Doctors treat autoimmune hepatitis with medicines that suppress the immune system, most often corticosteroids and immunosuppressants

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. These medicines may cause side effects. If autoimmune hepatitis leads to liver failure or liver cancer, a liver transplant may be necessary

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Drugs Used to Treat Autoimmune Hepatitis

Some of the drugs used to treat autoimmune hepatitis include:

• Prednisone
• Azathioprine
• Mycophenolate mofetil
• Tacrolimus
• Cyclosporine

Autoimmune Hepatitis and Liver Transplantation

In some cases, autoimmune hepatitis can lead to liver failure, and a liver transplant may be necessary

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Side Effects of Treating Autoimmune Hepatitis

The medicines used to treat autoimmune hepatitis may cause side effects, such as weight gain, mood changes, high blood pressure, and increased risk of infections

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Prognosis

With treatment, most people with autoimmune hepatitis can live normal lives

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. However, if left untreated, autoimmune hepatitis can lead to cirrhosis, liver failure, and even death

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Living with Autoimmune Hepatitis

It is important to follow a healthy lifestyle, including a balanced diet, regular exercise, and avoiding alcohol and smoking

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. People with autoimmune hepatitis should also get vaccinated against viruses that can cause liver disease

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. It is also important to take medications as prescribed and attend regular check-ups with a healthcare provider.

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wiley

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stanfordhealthcare

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medscape

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biomedcentral

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healthline

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mayoclinic

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