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Autoimmune Hepatitis

What is autoimmune hepatitis?

Hepatitis is the inflammation of the liver, resulting in liver cell damage and destruction. In autoimmune hepatitis, the body's own immune system destroys the cells of the liver. It is a chronic inflammatory liver disease with no known cause. It is associated with a disorder called hypergammaglobulinemia. Hypergammaglobulinemia is a disorder where there are too any circulating protein antibodies in the blood. A chronic infection or certain malignant blood diseases may cause hypergammaglobulinemia. Autoimmune hepatitis may resolve without treatment in some individuals, but, for the majority of individuals, it is chronic and can lead to cirrhosis and liver failure.

Autoimmune hepatitis may be classified as type 1 or type 2. Type 1 (classic) is the most common form. It may occur at any age but usually affects young women more than men. Also, other autoimmune disorders can be associated with type 1 such as thyroiditis, Grave's disease, and ulcerative colitis. Type 2 generally affects girls between the ages of two and 14, but does occur in adults.

What are the symptoms of autoimmune hepatitis?

The following are the most common symptoms of autoimmune hepatitis. However, each individual may experience symptoms differently. Symptoms may include:

  • jaundice - yellowing of the skin and eyes.
  • fatigue
  • abdominal pain
  • severe acne
  • joint pain
  • joint swelling
  • cessation of menses
  • chest pain
  • diarrhea
  • fever
  • large abdomen due to large liver and spleen
  • spider-like blood vessels in the skin
  • ascites - fluid build-up in the abdominal cavity.

The symptoms of autoimmune hepatitis may resemble other medical conditions or problems. Always consult your physician for a diagnosis.

How is autoimmune hepatitis diagnosed?

In addition to complete medical history and physical examination, diagnostic procedures for autoimmune hepatitis may include the following:

  • specific laboratory blood tests, such as the following:
    • liver function studies
    • cellular blood counts
    • bleeding times
    • electrolyte tests
    • tests for other chemicals in the body
    • autoimmune antibodies 
  • ultrasound (Also called sonography.) - a diagnostic imaging technique, which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs of the abdomen such as the liver, spleen, and kidneys and to assess blood flow through various vessels.
  • liver biopsy - a procedure in which tissue samples from the liver are removed (with a needle or during surgery) from the body for examination under a microscope.

Treatment for autoimmune hepatitis:

Specific treatment for autoimmune hepatitis will be determined by your physician based on:

  • your age, overall health, and medical history
  • extent of the disease
  • your tolerance for specific medications, procedures, or therapies
  • expectations for the course of the disease
  • your opinion or preference

The goal of treatment for autoimmune hepatitis is to drive the disease into remission (complete or partial absence of symptoms). This is done by taking corticosteroids and immunosuppressive medications. Remission may take six months to a year or longer to occur. If an individual develops liver failure, a liver transplant may be considered.

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Online Resources of Liver, Biliary, & Pancreatic Disorders

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