Autoimmune Hepatitis:
What is autoimmune hepatitis?
Autoimmune hepatitis is classified as either type I or II. Type I is the most common form in North America. It occurs at any age and is more common among women than men. About half of those with type I have other autoimmune disorders, such as type 1 diabetes, proliferative glomerulonephritis, thyroiditis, Graves' disease, Sjögren's syndrome, autoimmune anemia, and ulcerative colitis. Type II autoimmune hepatitis is less common, typically affecting girls ages 2 to 14, although adults can have it aswell.
What causes autoimmune hepatitis?
One job of the immune system is to protect the body from viruses, bacteria, and other living organisms. Usually, the immune system does not react against the body's own cells; however, sometimes it mistakenly attacks the cells that it is supposed to protect. This response is called autoimmunity. Researchers speculate that certain bacteria, viruses, toxins, and drugs trigger an autoimmune response in people who are genetically susceptible to developing an autoimmune disorder.
What are the symptoms of autoimmune hepatitis?
The most common symptom of autoimmune hepatitis is fatigue. Other common symptoms may include:
- Enlarged liver
- Jaundice (yellowing of the skin and eyes)
- Skin rashes
- Dark urine
- Loss of appetite
- Nausea
- Abdominal discomfort
- Joint pain
People in advanced stages of the disease are more likely to have symptoms such as fluid in the abdomen (ascites) or mental confusion. Women may stop having menstrual periods. Symptoms of autoimmune hepatitis range from mild to severe. Because severe viral hepatitis or hepatitis caused by a drug—for example, certain antibiotics—has the same symptoms, tests may be needed for an exact diagnosis. Your doctor should also review and rule out all your medicines before diagnosing autoimmune hepatitis.
Treatment options:
With proper treatment, autoimmune hepatitis can usually be controlled. Recent studies show that sustained response to treatment not only stops the disease from getting worse, but also may actually reverse some of the damage. The primary treatment is medicine to suppress the overactive immune system. Both types of autoimmune hepatitis are treated with a corticosteroid called prednisone. Another medicine, azathioprine (Imuran) is also used to treat autoimmune hepatitis. Like prednisone, azathioprine suppresses the immune system and reduces the side effects. Your doctor may prescribe azathioprine, in addition to prednisone, once your disease is under control. Most people will need to take prednisone, with or without azathioprine, for years. Some people take it for life. Corticosteroids may slow down the disease, but everyone is different. In about one out of every three people, treatment can eventually be stopped. After stopping, it is important to carefully monitor the condition and promptly report any new symptoms.
People who do not respond to standard immune therapy or who have severe side effects may benefit from other immunosuppressive agents like mycophenylate mofetil, cyclosporine or tacrolimus. People who progress to end stage liver disease (liver failure) and/or cirrhosis may need a liver transplant.
Additional patient resources:
| University of Missouri Health Care | This information is not intended to replace the advice of a doctor. |
