Autoimmune hepatitis is a disease in which the body’s own immune system attacks its liver cells. This causes hepatitis, or liver inflammation (irritation). Autoimmune hepatitis is not contagious and cannot be prevented.
About 70% of people with autoimmune hepatitis are women, most between 15 and 40. Untreated, this serious disease gets worse. It can last for years and can lead to liver cirrhosis (damaged, scarred liver) and liver failure.
The cause is unknown. A substance (antigen) may cause the immune system to attack liver cells. Most experts think that genetics may make some people more likely to have autoimmune diseases.
Fatigue is common. Other signs are enlarged liver (hepatomegaly), jaundice (yellowish skin), itching, rashes, joint pain, and discomfort in the abdomen (belly). Symptoms range from mild to severe.
People with advanced disease are more likely to have such symptoms as fluid in the abdomen (ascites) and mental confusion.
The health care provider makes a diagnosis on the basis of symptoms, blood test results, x-rays (ultrasound or computed tomography [CT] of the liver to rule out other causes), and liver biopsy.
Blood tests for liver enzymes and autoantibodies are needed. The tests also help tell autoimmune hepatitis from viral hepatitis (e.g., hepatitis A, B, or C) or metabolic diseases. Antibodies are proteins made by the immune system. In autoimmune hepatitis, antibodies attack and destroy liver cells. The pattern and level of these antibodies can tell the type of disease.
For a liver biopsy, a tiny liver sample is removed with a hollow needle and examined under a microscope.
The main treatment for both types is medicine (corticosteroid called prednisone) to slow an overactive immune system.
In most people, the disease goes into remission with proper treatment, but may recur. Lifelong treatment may be needed.
People who don’t respond to standard therapy or who have severe side effects may be helped by other immunosuppressive drugs.
People who develop liver failure may need a liver transplant, a promising treatment, with a 5-year survival rate of 70% to 80%.
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