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Autoimmune Hepatitis

  • Biliary System

Definition

Autoimmune hepatitis is an inflammation of the liver caused by an autoimmune disorder - one in which a person's immune system attacks his or her own body for reasons that are often unknown.

What is going on in the body?

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.

Risks

What are the causes and risks of the condition?

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.

Prevention

What can be done to prevent the condition?

Generally, nothing can be done to prevent autoimmune hepatitis.

Diagnosed

How is the condition diagnosed?

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.

Long Term Effects

What are the long-term effects of the condition?

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.

Other Risks

What are the risks to others?

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

Treatments

What are the treatments for the condition?

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.

Side Effects

What are the side effects of the treatments?

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.

After Treatment

What happens after treatment for the condition?

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.

Monitor

How is the condition monitored?

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.

Sources

Harrison's Principles of Internal Medicine, 1998, Fauci et al.

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