What is autoimmune hepatitis?

Autoimmune hepatitis is a condition in which your own white blood cells attack the liver and damage it. Under normal circumstances, white cells in our body protect us against invasion of foreign substances.  Sometimes, these white cells fail to identify liver as our own and they start damaging it.

What causes Autoimmune hepatitis?

The exact reason why these self protective cells turn against our liver is not known. However, it is believed to have environmental and genetic role. Some environmental agents alter the liver cells (known as hepatocytes) and lead to stimulation of immune system

What will happen if I develop autoimmune hepatitis?

Autoimmune Hepatitis also known as AIH will start scarring your liver and over a period of time it will permanently damage your liver. This is known as cirrhosis. Once cirrhosis develops, there would complications of cirrhosis – Bleeding, jaundice, ascites, swelling of feet, altered mentation and low urine output

What will be the symptoms of AUTOIMMUNE HEPATITIS?

There would be highly variable symptoms of AUTOIMMUNE HEPATITIS. Not all will have similar symptoms. Fatigue, lethargy and exhaustion remains most common and most ignored. Abdominal heaviness, joint pains, muscle aches remain common. There may be skin rash. Jaundice is present in nearly half. A lot of times this is fluctuating and as it disappears in between, people ignore it without investigating believing it to be acute viral hepatitis. Only when jaundice remains for few weeks to months they seek guidance of a hepatologist. Some times itching may be the presenting symptom.

What are the types of AUTOIMMUNE HEPATITIS?

Two main types of AUTOIMMUNE HEPATITIS are known.

Type 1 AUTOIMMUNE HEPATITIS – This is the most common type of the disease. It can occur at any age. About half the people with type 1 autoimmune hepatitis have other autoimmune disorders, such as celiac disease, rheumatoid arthritis or ulcerative colitis.

Type 2 AUTOIMMUNE HEPATITIS -Although adults can develop type 2 autoimmune hepatitis, it’s most common in children and young people. Other autoimmune diseases may accompany this type of autoimmune hepatitis.

How can I diagnose AUTOIMMUNE HEPATITIS?

AUTOIMMUNE HEPATITIS is usually suspected from history as it affects young women more than men. However, it can affect at any age and any gender. People as young as 4-5 years to as old as seventies can be affected. So AUTOIMMUNE HEPATITIS should be a differential diagnosis for all jaundice. Liver function tests raises the suspicion of AUTOIMMUNE HEPATITIS. SGPT (ALT) and SGOT (AST) are elevatedin these patients. Once viral disease and drug intake is excluded, your doctors would advice special tests for AUTOIMMUNE HEPATITIS. Once they turn out positive, liver biopsy is always needed to confirm and start treatment

Can AUTOIMMUNE HEPATITIS lead toliver failure?

AUTOIMMUNE HEPATITIS can lead to sudden liver failure and may be fatal unless treated urgently. They may warrant an urgent liver transplant. It may also lead to acute on chronic liver failure which may also not resolve without a liver transplant.

Can AUTOIMMUNE HEPATITIS be treated?

AUTOIMMUNE HEPATITIS can be treated by oral drugs. Steroids and immunosuppressants can lead remission of disease. The treatment in patients without cirrhosis can be withheld at 2-3 years. However, in patients of cirrhosis, it is usually lifelong. Default in treatment can sometimes lead to liver failure. Doctors typically prescribe prednisone at a high dose for about the first month of treatment. Then, to reduce the risk of side effects, they gradually reduce the dose over the next several months until reaching the lowest possible dose that controls the disease. Adding azathioprine also helps you avoid prednisone side effects.

Autoimmune Hepatitis

Patients with AUTOIMMUNE HEPATITIS developing acute liver failure, acute on chronic liver failure or developing complications of cirrhosis may warrant liver transplant. The transplant outcomes are very good and equivalent to transplant outcomes for other diseases. There is risk of developing AUTOIMMUNE HEPATITIS in new liver, although the severity remains less and rarely lead to complications.

If you have altered liver tests, do not ignore. Meet your hepatologist and rule out the possibility of AUTOIMMUNE HEPATITIS. Early diagnosis is linked with excellent outcomes