Autoimmune hepatitis

Lupoid hepatitis; Chronic acute liver disease

Last reviewed: November 23, 2010.

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

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