Autoimmune Hepatitis

Overview

Autoimmune hepatitis is a liver disorder that occurs when the body’s immune system turns against your liver cells.

If you have this condition, you must receive prompt diagnosis and treatment from an experienced liver specialist. If not properly diagnosed and effectively managed, autoimmune hepatitis can lead to a variety of serious complications, including cirrhosis of the liver and liver failure.

Autoimmune hepatitis types

There are two types of autoimmune hepatitis.

Type 1 autoimmune hepatitis

The most common type of the disorder, it can be diagnosed at any age. This type frequently occurs in people who also have other autoimmune conditions, such as celiac disease, rheumatoid arthritis (RA) or ulcerative colitis (UC).

Type 2 autoimmune hepatitis

This type is most common in children and young adults, though it can occur at any age. Some people with this type also have other autoimmune conditions.

Autoimmune hepatitis causes

Experts haven’t yet pinpointed the reason that the immune system mistakenly attacks the liver, but they believe that certain genetic and environmental factors may play a role.

Autoimmune hepatitis risk factors

Factors that put you at an increased risk for developing autoimmune hepatitis can include:

• Being female
• Having a family history of autoimmune hepatitis
• Having a history of measles, herpes simplex or Epstein-Barr virus
• Having an autoimmune condition, such as celiac disease, RA, Graves’ disease or Hashimoto’s thyroiditis
• Having hepatitis A, B or C

Autoimmune hepatitis symptoms

Signs and symptoms of autoimmune hepatitis may include:

• Abdominal discomfort
• Enlarged liver
• Fatigue
• Jaundice (yellowing of the skin and eyes)
• Loss of menstrual periods
• Pain in your joints
• Spider angiomas (unusual blood vessels on the skin)
• Unexplainable skin rashes

Autoimmune hepatitis diagnosis

Your specialist will use one or more of the following diagnostic tools to diagnose autoimmune hepatitis:

• Blood tests - your specialist will obtain a sample of your blood for close analysis in the lab. If your blood contains certain antibodies, your specialist can tell determine whether you have autoimmune hepatitis or another condition with similar symptoms, such as viral hepatitis. Blood tests can also help your specialist determine which type of autoimmune hepatitis you have.
• Liver biopsy - your specialist may perform this procedure in he or she removes a tiny tissue sample (biopsy) from your liver. Lab technicians closely analyze the tissue sample in the lab for markers of autoimmune hepatitis and signs of liver damage. A liver biopsy also helps your specialist determine the type of liver damage you have.

Autoimmune hepatitis treatment

For both types of autoimmune hepatitis, the goal of treatment is to decrease or stop your immune system’s attack on your liver. To this end, your specialist will likely prescribe medications that suppress the immune system.

In most cases, you will take a round of the steroid medication prednisone as the initial course of treatment, typically for about a month. Your doctor will taper off your dose of prednisone slowly until you are taking the lowest dose possible that is effective to manage your autoimmune hepatitis.

You may also need to take another medication called azathioprine to help reduce the troublesome side effects of prednisone, which can include weight gain.

You may need to take immune suppressing medicines for the rest of your life to avoid flareups.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a liver specialist for more specialized treatment.