Autoimmune Hepatitis

There are different causes of chronic liver inflammation or hepatitis. One of these is autoimmune hepatitis, which is not a common condition. It is not known what causes autoimmune hepatitis, but with proper treatment, the outlook for affected patients is quite good. However, without treatment, it can lead to chronic liver disease, scarring (cirrhosis) and liver failure.

What Is Autoimmune Hepatitis?

Autoimmune hepatitis is a condition in which the immune system of the body mistakenly attacks the healthy liver, causing chronic inflammation. Two types of the disease occur. Type 1 autoimmune hepatitis, which is more common, is the classic type, and it affects mostly young women. It is also usually associated with other types of autoimmune conditions. The less common form, Type 2 autoimmune hepatitis, affects mostly younger girls who are from 2-14 ages. Recognizing this condition is important because if untreated, autoimmune hepatitis can cause liver scarring and failure of liver function.

Symptoms and Complications of Autoimmune Hepatitis

1. Symptoms

Autoimmune hepatitis can manifest with a range of symptoms that may be mild to severe. They may occur suddenly or develop gradually. Some people experience few symptoms in its early stages, while others experience more symptoms that may include:

Itching
Fatigue
Joint pain
Skin rashes
Loss of appetite
Liver enlargement
Dark-colored urine
Loss of menstruation
Nausea and vomiting
Abdominal discomfort
Yellowing of the skin and eyes
Unusual blood vessels (spider angiomas)on the skin

2. Complications

Some of the potential complications of autoimmune hepatitis include:

Scarring (cirrhosis)of the liver
Liver cancer
Liver failure
Accumulation of fluid in the abdomen
Portal hypertension or increased blood pressure in the main blood vessel of the liver (portal vein)
Enlargement of the veins in the esophagus (esophageal varices) and stomach

Causes and Risk factors of Autoimmune Hepatitis

The immune system protects the body by attacking viruses,bacteria, or other organisms that invade the body. However, sometimes it mistakenly attacks its own tissues, causing an abnormal response called autoimmunity. People who develop autoimmune hepatitis suffer from chronic inflammation of the liver due to an immune attack of its own cells. Scientists have not found the exact reason why this happens, but previous infections and heredity factors may play a role.

Some of the risk factors involved in autoimmune hepatitis include:

Age. While Type 1 autoimmune hepatitis affect people at any age, young girls are more likely to suffer from type 2autoimmune hepatitis.
Gender. The disease is more likely to affect females than males.
Previous infections. A history of a viral or bacterial infection can increase one’s risk of the disease.
Certain medications. Some medications, such as antibiotics (minocycline and the anti-cholesterol medications (atorvastatin), have been linked to autoimmune hepatitis.
Heredity. Studies suggest that autoimmune hepatitis may be inherited from relatives.
Other autoimmune diseases. People who have another autoimmune condition may also develop autoimmune hepatitis.

Treatments for Autoimmune Hepatitis

1. Medications

Treatment of autoimmune hepatitis may include medications such as:

Medication	Description
Prednisone	This is a corticosteroid drug, which may be prescribed in high doses initially to control inflammation of the liver. It is then reduced to lower doses over a few weeks. Remission or improvement may take some time after starting treatment, but the disease may return if prednisone is discontinued. Chronic intake of prednisone can lead to serious side effects such as obesity, diabetes, weak bones, high blood pressure, glaucoma and cataracts.
Azathioprine (Imuran)	This is another medication that suppresses the immune system (immunosuppressant), and it is sometimes combined with prednisone treatment. Using them together allows you to take smaller doses of prednisone, thus reducing its unwanted effects. Azathioprine side effects may include nausea and difficulty fighting infections. Rarely, it can also cause liver damage, inflammation of the pancreas (pancreatitis) or cancer.
Other Immunosuppressants	If prednisone and/or azathioprine do not work, your doctor may prescribe other immunosuppressants, including mycophenolate (CellCept), tacrolimus (Prograf) and cyclosporine (Neoral, Sandimmune).

2. Liver Transplant

This option is taken when other treatments do not work, or if your liver undergoes cirrhosis which is irreversible. A liver transplant is needed when liver failure occurs because the liver is a vital organ which you need to sustain life.

A liver transplant involves removing the diseased liver and replacing it with a healthy liver that comes from an organ donor, usually deceased. However, in some cases, you may receive just a healthy portion of a liver from a living donor. After the successful transplant, your new liver, as well as the donor’s remaining liver, will regenerate new cells and restore function immediately.