This page: What is autoimmune hepatitis? Autoimmune hepatitis affects the liver. Autoimmune hepatitis is a disease in which the body's immune system attacks liver cells. This immune lasix online no prescription response causes inflammation of the liver, also called hepatitis. Researchers believe that genetic factors may make some people more susceptible to autoimmune diseases. About 70 percent of those with autoimmune hepatitis are women. The disease is usually quite serious and if not treated, gets worse over time. Autoimmune hepatitis is usually chronic, meaning it can last for years and can lead to cirrhosis, scarring and strengthening the liver. Finally, hepatic failure may result. Autoimmune hepatitis is classified as type 1 or type 2. Type 1 is the most common form in North America. This can happen at any age but often begins in adolescence or early adulthood. About half of those with type 1 has other autoimmune diseases such as proliferative glomerulonephritis
, inflammation of blood vessels in the kidney
thyroiditis, inflammatory disease of the thyroid gland
Graves, the main cause of symptoms of hyperactivity thyroid
Sjgren, in a syndrome that causes dry eyes and mouth, autoimmune anemia
ulcerative colitis, an inflammation of colon and rectum causes ulcers
type 2 autoimmune hepatitis is less common, usually a applies to girls aged 2 to 14, although adults may be it too. [What is autoimmune disease? One of the objectives of the immune system is to protect the body against viruses, bacteria and other organisms.
The immune system normally does not react against its own cells. However, sometimes attacks the cells it should protect, it is called autoimmune response. Researchers believe that some bacteria, viruses, toxins, drugs cause the immune response in people genetically susceptible to development of autoimmune disorders. [What are the symptoms of autoimmune hepatitis? Fatigue is probably the most common symptom of autoimmune hepatitis. Other symptoms include spider angiomas
, or abnormal blood vessels in the skin
People in the later stages of disease are more likely to have symptoms associated with chronic liver disease, such as fluid in the abdomen, also called ascites and confusion. Women may stop having menstrual periods >>. Symptoms << autoimmune hepatitis range from mild to severe. A severe viral hepatitis or hepatitis caused by drugs such as some antibiotics, have the same symptoms as autoimmune hepatitis, tests may be necessary for accurate diagnosis. Physicians should also consider the exclusion of all medications the patient takes to the diagnosis of autoimmune hepatitis. [How autoimmune hepatitis diagnosed? The doctor diagnoses based on symptoms, blood tests and liver biopsy. Blood tests. Routine blood tests for liver enzymes can help identify the typical pattern of hepatitis, but further research, especially for autoantibodies, necessary for the diagnosis of autoimmune hepatitis. Antibodies are proteins made by the immune system to fight bacteria and viruses. Autoantibodies attack the body cells. In autoimmune hepatitis, the immune system makes one or more types of autoantibodies. The most common are anti-nuclear antibodies (ANA), smooth muscle antibodies (SMA) and antibodies to liver and kidney microsomes (anti-LKM). People with type 1 diabetes in ANA, SMA, or both, and people with type 2 diabetes with anti-LKM. Blood tests also help distinguish autoimmune hepatitis from other diseases that are similar to it, such as viral hepatitis B or C, or metabolic diseases such as Wilson disease. Liver biopsy. Tiny sample of liver tissue, examined under a microscope could help doctors to put an accurate diagnosis of autoimmune hepatitis and tell how it seriously. This procedure is performed in an outpatient hospital or surgical facility. [How to treat autoimmune hepatitis? Treatment works best when autoimmune hepatitis is diagnosed early. With proper treatment, autoimmune hepatitis, usually under control. In fact, studies show that sustained response to treatment stops the disease from getting worse and may negate some damage. The main treatment medicine to suppress or slow down an overactive immune system. Both types of autoimmune hepatitis are treated with daily doses of corticosteroid called prednisone. Treatment may begin with a high dose of 30 to 60 mg per day and be reduced to 10 to 20 mg per day, as the disease under control. The goal is to find the lowest dose that will control the disease. Other drugs, azathioprine (Imuran) is also used to treat autoimmune hepatitis. Like prednisone, azathioprine suppresses the immune system, but different. Treatment may begin with both azathioprine and prednisone, azathioprine, or can be added later when the disease is under control. The use of azathioprine allows lower doses of prednisolone, which, in turn, reduces the effect predisone side. In seven out of 10 people, the disease goes into remission for 3 years from start of treatment. Remission is when the symptoms disappear and lab tests showed improvement of liver function. Some people may eventually discontinue treatment, although many will see the return of the disease. People who stop treatment should carefully monitor their condition and promptly report any new symptoms to the doctor. Treatment with low doses of prednisolone or azathioprine may be necessary on and off for years, if not for life. Some people with milder forms of the disease do not have to take medication. Doctors assess each patient individually to determine those with mild autoimmune hepatitis should undergo treatment. [What are the side effects of prednisolone and azathioprine? Both prednisone and azathioprine have side effects. Because high doses of prednisone are often needed to control autoimmune hepatitis, managing side effects is very important. However, most side effects appear only after a long period of time. thinning bones, a condition called osteoporosis
azathioprine may reduce white blood cells, and sometimes causes nausea and anorexia. Rare side effects: allergic reactions, liver damage, pancreatitis, which is an inflammation of the pancreas with severe abdominal pain. [Are there other treatments for autoimmune hepatitis available? People who do not respond to standard immunotherapy or who have serious side effects may benefit from other immunosuppressive drugs, such as mycophenylate mofetylu, cyclosporine or tacrolimus. People who progress to end-stage liver disease, also called liver failure or liver cirrhosis may require liver transplantation. Transplantation of a 1-year survival rate is 90 percent and 5-year survival ranges from 70 to 80 percent. [Autoimmune hepatitis is a long-term disease in which the body's immune system attacks liver cells. The disease is diagnosed through various blood tests and liver biopsy. With proper treatment, autoimmune hepatitis, usually under control. The main treatment drug that suppresses an overactive immune system. [Scientists are studying various aspects of autoimmune hepatitis to find out who gets and why and to discover better ways of treatment. Fundamental research on the immune system will expand knowledge of autoimmune diseases in general. Epidemiological studies help doctors understand what causes autoimmune hepatitis in some people. Research the different steroids, alternatives to steroids and other immunosuppressants will eventually lead to more effective treatment. [American Association for the Study of Liver Diseases 1001 North Fairfax, Suite 400
Alexandria, VA 22314
E-mail: Internet: American Liver Foundation 75 Maiden Lane, Suite 603
New York, NY 10038 - 4810
Phone: 1-800-GO-LIVER (465-4837), 1-888-4HEP-USA (443-7872) or 212-668-1000
E-mail: Internet: [ Bethesda, MD 208923570
E-mail: Internet: National Digestive Diseases Information Clearing (NDDIC) is a service of the National Institute of Diabetes, gastrointestinal and renal diseases (NIDDK). NIDDK is part of the National Institutes of Health U.S. Department of Health and Human Services. Founded in 1980, the Clearinghouse provides information about diseases of the digestive system of people with digestive disorders and their families, health professionals and the public. NDDIC answers the question, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about digestive diseases. Publications on the Clearinghouse are carefully reviewed both scientists and outside experts NIDDK. This publication has been reviewed by
Willis Maddrey, MD, University of Texas Southwestern Medical Center at Dallas, and Edward Krawitt, MD, University of Vermont College of Medicine. This publication is not copyrighted. Information Center encourages users of this publication may copy and distribute as many copies as needed. NIH Publication № 08-4761
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