Autoimmune hepatitis
Definition
Autoimmune hepatitis is inflammation of the liver that occurs when immune cells mistake the liver's normal cells for harmful invaders and attack them.
Alternative Names
Lupoid hepatitis; Chronic acute liver disease
Causes, incidence, and risk factors
In patients who have an autoimmune disease, the immune system can't 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, including:
- Graves disease
- Inflammatory bowel disease
- Rheumatoid arthritis
- Scleroderma
- Sjogren syndrome
- Systemic lupus erythematosus
- Thyroiditis
- Type 1 diabetes
- Ulcerative colitis
Autoimmune hepatitis sometimes occurs in relatives of people with autoimmune diseases, which suggests that there is a genetic cause.
This disease is most common in young girls and women.
Symptoms
- Abdominal distention
- Dark urine
- Fatigue
- General discomfort, uneasiness, or ill feeling (malaise)
- Itching
- Loss of appetite
- Nausea or vomiting
- Pale or clay-colored stools
Other symptoms that may occur with this disease include absence of menstruation (amenorrhea).
Signs and tests
- Abnormal liver function tests
- Liver biopsy showing chronic hepatitis
Tests for autoimmune hepatitis:
- Anti-liver kidney microsome type 1 antibody (anti LKM-1)
- Anti-nuclear antibody (ANA)
- Anti-smooth muscle antibody (SMA)
- Serum IgG
Treatment
Prednisone or other corticosteroid medications help reduce the inflammation. Azathioprine and 6-mercaptopurine are drugs used to treat other autoimmune disorders. They have been shown to help patients with autoimmune hepatitis, as well.
Some patients may receive a liver transplant.
Expectations (prognosis)
The outcome varies. Corticosteroid therapy may slow the disease progression. However, autoimmune hepatitis may worsen to cirrhosis and require a liver transplant.
Complications
- Cirrhosis
- Complications related to steroids and other medications
- Hepatocellular carcinoma
- Liver failure
Calling your health care provider
Call your health care provider if you notice symptoms of autoimmune hepatitis.
Prevention
Autoimmune hepatitis is usually not preventable. Awareness of risk factors may allow early detection and treatment.
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: Saunders Elsevier; 2010:chap 88.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
CaringBridge
Facebook
LinkedIn
Twitter
YouTube