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Autoimmune Hepatitis: Causes, Symptoms, Diagnosis & Treatment

Autoimmune hepatitis (AIH) occurs when the body's immune system starts to attack the liver cells, causing liver inflammation. Early diagnosis and treatment of autoimmune hepatitis can aid in managing the symptoms and prevent liver cirrhosis (scarring).

What Causes Autoimmune Hepatitis?

  • Autoimmune hepatitis cause is unknown, however, other possible triggers are:
  • Genes
  • History of bacterial or viral infections
  • The use of certain medications like hydralazine, minocycline, statins, and nitrofurantoin

Other autoimmune conditions are also linked with the development of autoimmune hepatitis. These include the following:

  • Grave's disease
  • Type 1 diabetes
  • Rheumatoid arthritis
  • Thyroiditis
  • Ulcerative colitis
  • Inflammatory bowel disease
  • Scleroderma
  • Systemic lupus erythematosus
  • Sjögren's syndrome

Types Of Autoimmune Hepatitis

  • Type 1 autoimmune hepatitis - It is the most common type of hepatitis and can occur at any age [1] .
  • Type 2 autoimmune hepatitis - It is most common in children and young people. Adults also can develop this type of hepatitis [2] .

Symptoms Of Autoimmune Hepatitis

  • Joint pain
  • Skin rashes
  • Fatigue
  • Nausea and vomiting
  • Diarrhoea
  • An enlarged liver
  • Jaundice
  • Loss of menstrual periods
  • Stomach pain
  • Abnormal blood vessels on the skin
  • Weight loss

Risk Factors Of Autoimmune Hepatitis

  • The disease is common in females
  • A history of having certain infections like measles, herpes simplex or Epstein-Barr virus.
  • Heredity
  • People who already have an autoimmune disease like celiac disease, hyperthyroidism, and rheumatoid arthritis.

Complications Of Autoimmune Hepatitis

  • Enlarged veins in your oesophagus
  • Liver failure
  • Liver cancer
  • Fluid in the abdomen

Diagnosis Of Autoimmune Hepatitis

  • Blood tests - Blood tests are done to rule out viral hepatitis, determine the type of AIH you have, and check the functioning of the liver.
  • Liver biopsy - A doctor will perform a liver biopsy to determine the extent and the type of liver damage.

Treatment For Autoimmune Hepatitis

The treatment will help to slow down, stop and reverse liver damage. The treatment options are:

Liver transplant

A liver transplant can aid in the treatment of AIH, however, the disease can sometimes recur after a liver transplant as well. According to the National Institute of Diabetes and Digestive and Kidney Diseases, there is an 86% survival rate for people with a liver transplant.

Immunosuppressant drugs

Immunosuppressant drugs such as azathioprine and 6-mercaptopurine can be used to inhibit the immune system's attack and help in fighting other infections.

Corticosteroids

Corticosteroids in the form of prednisone can treat liver inflammation as well. Prednisone is likely to be taken for a minimum of 18-24 months. To prevent autoimmune hepatitis from recurring, some people should continue taking the drug throughout their life. However, it has its side effects too such as diabetes, weight gain, blood pressure, and osteoporosis.

View Article References
  1. [1] Homberg, J. C., Abuaf, N., Bernard, O., Islam, S., Alvarez, F., Khalil, S. H., ... & Opolon, P. (1987). Chronic active hepatitis associated with antiliver/kidney microsome antibody type 1: a second type of “autoimmune” hepatitis. Hepatology, 7(6), 1333-1339.
  2. [2] Lenzi, M., Ballardini, G., Fusconi, M., Cassani, F., Selleri, L., Volta, U., ... & Bianchi, F. B. (1990). Type 2 autoimmune hepatitis and hepatitis C virus infection. The Lancet, 335(8684), 258-259.
  3. [3] Beretta-Piccoli, B. T., Mieli-Vergani, G., & Vergani, D. (2017). Autoimmune hepatitis: standard treatment and systematic review of alternative treatments. World journal of gastroenterology, 23(33), 6030.

Story first published: Sunday, July 28, 2019, 11:00 [IST]
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