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Autoimmune hepatitis
Definition
Autoimmune hepatitis is inflammation of the liver that occurs when immune cells mistake the liver's normal cells for harmful invaders and attack them.
Alternative Names
Lupoid hepatitis; Chronic acute liver disease
Causes
This form of hepatitis is an autoimmune disease. The body's 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. This suggests that there may be 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).
Exams and Tests
Tests for autoimmune hepatitis include:
- Anti-liver kidney microsome type 1 antibody (anti LKM-1)
- Anti-nuclear antibody (ANA)
- Anti-smooth muscle antibody (SMA)
- Serum IgG
- Liver function tests
- Liver biopsy to look for chronic hepatitis
Treatment
You may need prednisone or other corticosteroid medicines help reduce the inflammation. Azathioprine and 6-mercaptopurine are drugs used to treat other autoimmune disorders. They have been shown to help people with autoimmune hepatitis, as well.
Some people may need a liver transplant.
Outlook (Prognosis)
The outcome varies. Corticosteroid medicines may slow the progress of the disease. However, autoimmune hepatitis may advance to cirrhosis. This would require a liver transplant.
Possible Complications
- Cirrhosis
- Side effects from steroids and other medicines
- Hepatocellular carcinoma
- Liver failure
When to Contact a Medical Professional
Call your health care provider if you notice symptoms of autoimmune hepatitis.
Prevention
Autoimmune hepatitis is usually cannot be prevented. Knowing the risk factors may allow early detection and treatment.
References
Czaia AJ. Autoimmune hepatitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 88.
Reviewed By: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, and Stephanie Slon.
