Autoimmune hepatitis is when the immune system mistakenly attacks the liver, causing damage and swelling. Treatment involves managing the symptoms and using medication to suppress the immune system.
Although less prevalent than other forms of hepatitis, researchers are still uncertain how common autoimmune hepatitis is in the population. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) point out research from northern Europe that shows an estimated 10 to 24 out of every 100,000 people have autoimmune hepatitis.
The disease may be a lifelong one. However, most people can manage the symptoms, bring the condition into remission, and slow liver damage.
Symptoms of autoimmune hepatitis can vary.
This may be due to the severity of the initial liver damage is in each case, and people may experience many different symptoms, ranging from mild to severe. These may include:
Anyone with these symptoms who does not have a diagnosis should see a doctor.
Sometimes a person with autoimmune hepatitis may show little or no symptoms until scar tissue from cirrhosis causes its own complications. Other symptoms may show up, as the disorder progresses, and more liver tissue becomes damaged.
These could include:
- loss of weight
- swollen legs, ankles, and feet
- itchy skin
- fluid in the abdomen
Not all symptoms will show up in everyone with the disorder. More symptoms may show up if the person has other issues in addition to autoimmune hepatitis, such as other autoimmune conditions.
Complications may also occur if there is too much damage to the liver or if the person leaves the condition for too long without receiving treatment. Complications can be serious and include:
- cirrhosis or scar tissue on the liver
- liver failure or end-stage liver disease
- liver cancer
Complications may require extensive treatments, and a person may need a liver transplant in some cases.
What are the causes?
There is still no known direct cause for autoimmune hepatitis. The Genetic and Rare Diseases Information Center note that people who have a family history of autoimmune conditions, or those with other autoimmune diseases, may be more likely to get autoimmune hepatitis.
According to the NIDDK, some common medicines may cause autoimmune liver injury, including the antibiotics minocycline and nitrofurantoin. However, in these cases, the symptoms typically clear up once the person stops taking the medication.
No matter what triggers the disease, the cause of the symptoms is damage to the liver. The immune system in the body gets wrong signals about normal cells, mistaking them for invading cells. It attacks these cells and damages the liver tissue, leading to symptoms over time.
If a person suspects they may have liver damage, they should see a doctor.
Doctors will ask about:
- medical history
- lifestyle habits, such as alcohol or drug use
A doctor will often request blood tests first and may also order a biopsy.
During a biopsy, a doctor will take a small piece of liver tissue and examine the cells for damage. They will then test for specific antibodies to determine the type of autoimmune hepatitis a person is exhibiting.
The goal of treatment is to suppress symptoms and control the disease, as best as possible.
The first treatment many doctors provide is corticosteroids or immune system-suppressing drugs. These medications work to lower activity of the immune system in general, which may help slow the attack on the liver.
Treatment will also include regular blood tests to be sure the body is responding well to the treatment.
It is possible for autoimmune hepatitis to fail to respond to treatment, and doctors may recommend additional drugs to control inflammation or prevent liver damage. In these cases, people may be more at risk of complications that then require their own treatments.
How can diet improve the condition?
Doctors may, however, recommend changes in diet, as part of a general treatment plan. This may be especially important if damage to the liver leads to complications, such as cirrhosis.
Doctors will warn people to avoid alcohol in most cases, as autoimmune hepatitis can damage the liver.
The condition may go into remission with the correct treatment plan. Remission occurs when symptoms disappear, and test results show normal liver function.
Doctors will often carefully reduce any medications the person is taking during remission, and it is essential to perform liver function tests to check for enzyme levels and see if symptoms return.
Doctors may try several medications to achieve remission. If a person relapses, their doctor will restart or increase their medication to bring symptoms under control again and return to remission.
Autoimmune hepatitis often lasts a lifetime. People need to work closely with a doctor to monitor symptoms and control the condition. This also helps prevent any potentially serious complications. Many people find effective treatments that provide relief and help manage the condition.
Anyone who is uncertain about their treatment should talk to a doctor about the options. It is essential that people tell their doctor about all medications and supplements they use, as there may be interactions that cause unforeseen complications.
Regular checkups and adjustments in medication are crucial for successful treatment, and many people can find ways to control their symptoms and force the condition into remission.