Autoimmune Hepatitis

The exact reasons for autoimmune disorders are often not well understood. In autoimmune hepatitis, the immune system attacks the liver and, sometimes, other parts of the body. The degree of liver inflammation can range from mild to deadly.

Autoimmune hepatitis can cause many symptoms, including:

• abdominal distress
• nausea and vomiting
• jaundice, which is a yellowing of the whites of the eyes and skin
• dark-colored urine
• loss of appetite
• fatigue
• fever

Some individuals with autoimmune hepatitis develop bodywide symptoms such as joint pain, skin and nail changes, muscle aches, and blood clotting problems.

The cause of autoimmune hepatitis is unknown. It may be an isolated condition or may occur as part of another autoimmune disorder, such as systemic lupus erythematosus. While these diseases are not inherited specifically, a person is predisposed to the condition if he or she has a family member with an autoimmune disorder. While the condition is seen in men, it is eight times more common in women, most often between the ages of 15 and 40.

Generally, nothing can be done to prevent autoimmune hepatitis.

Hepatitis, which means "liver inflammation" can be diagnosed with blood tests, such as liver function tests. The provider must then try to figure out the cause of the hepatitis. Conditions such as alcoholism and viral infection of the liver are much more common than autoimmune hepatitis. Further blood tests, including one that measures antibodies to the person's own tissues, often help make the correct diagnosis. Special X-ray tests may be needed as well.

Sometimes, a liver biopsy may be needed. This procedure involves getting a piece of liver tissue with a special needle inserted through the skin. The piece can then be examined under a microscope in the laboratory.

Cirrhosis, a chronic condition that means scarring of the liver, is often seen in people with autoimmune hepatitis over time. This may cause malfunctioning of the liver and even death.

Autoimmune hepatitis is not contagious and poses no risk to others.

Autoimmune hepatitis is treated with medications that stop the immune system from attacking the liver. These medications include steroids, such as prednisone, and azathioprine (i.e., Azasan, Imuran). A liver transplant may be needed if medications don't work or the liver becomes very damaged.

Medications to suppress or stop the immune system can cause allergic reactions, stomach upset, and an increased risk of infection. Liver transplant is major surgery that can be complicated by bleeding, infection, or an allergic reaction to the anesthetic.

The outcome for autoimmune hepatitis is often unpredictable, especially since there are several types. A person may require lifelong therapy or the condition may go away on its own for long stretches of time. A liver transplant generally cures the condition but requires intense treatment and monitoring for years after the transplant.

Regular physical examinations and liver function blood tests are commonly used to monitor autoimmune hepatitis. Any new or worsening symptoms should be reported to the healthcare provider.