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Autoimmune hepatitis

Lupoid hepatitis; Chronic acute liver disease

 

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
  • Sjogren 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:

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

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

 

Exams and Tests

 

Tests for autoimmune hepatitis include:

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

 

Treatment

 

You may need prednisone or other corticosteroid medicines 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

Czaia AJ. Autoimmune hepatitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 88.

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    A Closer Look

     

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      Tests for Autoimmune hepatitis

       
       

      Review Date: 11/20/2014

      Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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