What is Autoimmune Hepatitis?
Autoimmune Hepatitis is a disease in which the body’s immune system attacks the liver cells. Like Ulcerative Colitis, and other autoimmune diseases, Autoimmune Hepatits causes inflammation of the affected organ. If left untreated over time, this disease can lead to cirrhosis pf the liver, and eventually liver failure.
This chronic condition is potentially fatal.
Type 1 Autoimmune Hepatitis, in, many cases, also occurs with other autoimmune disorders such as Ulcerative Colitis, type 1 diabetes, autoimmune anemia, Graves’ disease, Sjögren’s syndrome, thyroiditis and proliferative glomerulonephritis.
Type 2 Autoimmune Hepatitis is less common and mostly affects girls ages 2 to 14; however this type can also be found in adults.
Symptoms of autoimmune hepatitis range from mild to severe. The symptoms may include fatigue, abdominal discomfort, joint pain, skin rash, enlarged liver, jaundice, itching, nausea, vomiting, dark urine, loss of appetite, abnormal blood vessels on the skin, fatigue and pale or gray colored stools.
Mental confusion and fluid in the abdomen can sometimes be found in patients with advanced stages of the disease. Please note that the symptoms of viral hepatitis and other forms of hepatitis that are caused by a drug are very similar.
With this in mind, other tests may be needed by a physician to rule out these other forms of disease, and to confirm Autoimmune Hepatitis.
Diagnosis of autoimmune hepatitis is based on symptoms as well as a liver biopsy and blood tests. For a liver biopsy, the patient goes to an outpatient surgical center or to a hospital. The doctor will take a small sample of liver tissue to examine under a microscope. This examination will accurately diagnose autoimmune hepatitis and it’s seriousness.
While a routine blood test can reveal a patterns that are typical in a hepatitis case, further blood test are needed to diagnose autoimmune hepatitis especially for autoantibodies. The pattern and the level of antibodies in the blood help define if the disease is a type 1 or type 2 classification. These tests will also help distinguish autoimmune hepatitis from other forms of hepatitis.
Treatment for autoimmune hepatitis is most effective when the disease is diagnosed early. Treatment consists primarily of medications that suppress the immune system. To treat the disease, the doctor may prescribe prednisone, which is a corticosteroid. Prednisone, or other corticosteroids may have some unpleasant side effects.
These side effects increased acne, filling or rounding out of the face, weight gain, thinning of bones, thinning of hair and skin, high blood pressure, diabetes, cataracts, glaucoma, depression, anxiety and confusion. Athzathioprine (Imuran) is another medication that is prescribed in the treatment of autoimmune hepatitis.
Like prednisone, this medicine is also used to suppress the immune system as well as helping lower the doses of prednisone needed while reducing it’s side effects. Once the disease is under control, the physician may prescribe azathioprine, in addition to prednisone. Possible side effects of azathioprine may include lowered blood cell count, nausea and poor appetite.
Rare side effects include an allergic reaction, pancreatitis and liver damage. The duration of treatment varies from individual to individual in that some may eventually stop treatment followed by close monitoring or in some cases it may be necessary to contintue the treatments for life. However, for those whose treatment has been stopped, it is possible that the disease may return even worse than before, especially during the first few months after stopping treatment.
Within 2 years of starting treatment, 7 out of 10 people will have the disease go into remission. However, the symptoms will return within 3 years, so treatment for autoimmune hepatitis is an ongoing process. Other treatments are also possible for those patients who do not respond to standard immune therapy or who have severe side effects.
These include medicines such as tacrolimus, cyclosporine or mycophenylate mofetil, which are also immunosuppressive agents. Liver transplants are needed for those with cirrhosis and or end stage liver disease.