What Is Autoimmune Hepatitis?
Autoimmune hepatitis is a disease characterized by inflammation of the liver, and when the immune system of our body turns against our liver cells, autoimmune hepatitis occurs. The immune system normally protects the human body from external viruses, bacteria, or infection, which can cause serious harm to the body. Basically, the exact reason behind this disease is unclear. Primarily, it is thought by the specialists that genetic or environmental aspects are responsible for the disease. Like other hepatitis diseases, this condition may also lead a person to liver failure or liver cancer.
Types of Autoimmune Hepatitis
There are two kinds of autoimmune hepatitis:
- Type 1 - This is the most prevalent form of the disease. A person can be affected at any age. People who actually have other autoimmune conditions like rheumatoid arthritis and ulcerative colitis are more likely to develop autoimmune hepatitis. Region wise, type 1 is frequently found in North America.
- Type 2 - Not only adults but children and babies can also be infected with type 2 autoimmune hepatitis. Additional autoimmune diseases might be found alongside this autoimmune hepatitis.
Causes
When our body’s immune system fights against itself and targets our organs like the liver instead of targeting viruses, bacteria, and other pathogens, autoimmune hepatitis occurs. This attack may lead to different liver problems including liver cancer, which causes serious harm. Scientists remain uncertain about this disease since they did not find a clear explanation as to why our body turns against the liver. Using certain medications, for example minocycline, has been linked to causing autoimmune hepatitis. There are a few other autoimmune diseases that can lead to the development of autoimmune hepatitis. They include:
- Thyroiditis
- Scleroderma
- Inflammatory bowel disease (IBS)
- Systemic lupus erythematosus (SLE)
- Sjogren's syndrome
- Type 1 diabetes
- Graves' disease
- Ulcerative colitis
- Rheumatoid arthritis
Symptoms
The symptoms of autoimmune hepatitis may come suddenly but the symptoms will be minor. Symptoms include:
- Fatigue
- Abdominal pain
- Jaundice (the skin and the white part of the eyes become yellow)
- An enlarged liver
- Rashes on the skin
- Pale-colored stools
- Dark urine
- Itching caused by a buildup of toxins and bile
- Loss of appetite
- Vomiting
- Joint pain
- Blood vessels on the surface of the skin
Risk Factors
Factors that may amplify the threat of autoimmune hepatitis:
- Being female - Yet both males and females are at risk of having the condition, the disease is more regularly seen in women. Usually, women between the age of 15 to 40 are more likely to develop autoimmune hepatitis.
- History of a specific infection - If you have a previous record of getting infected with hepatitis A, B, or C, or any other diseases such as measles, herpes simplex infection, or mononucleosis, then you are at risk of developing autoimmune hepatitis.
Diagnosis
The diagnosis of autoimmune hepatitis could be a little difficult. Because ultimately, all other types of hepatitis also cause damage to the liver, and the symptoms are also more or less the same.
To identify autoimmune hepatitis, your doctor may require the following tests:
- Blood tests - Autoimmune hepatitis symptoms are quite similar to other hepatitis infections. However, blood tests can differentiate autoimmune hepatitis from other hepatitis diseases. Antibody tests can also determine if anyone is infected with autoimmune hepatitis. Blood tests also measure the amount of immunoglobulin G (IgG) antibodies in your blood. IgG antibodies help the body fight infection and inflammation.
- Liver biopsy - To identify the type and level of hepatitis, your doctor may ask for a liver biopsy report. A liver biopsy is a process where tissues are removed from the affected part of the liver. A thin needle is being used to pass through your skin to take liver cells. To do the analysis, the sample is then sent to the laboratory. Your doctor may also use an ultrasound to guide the biopsy procedure. Your doctor may also ask you to stop taking any medicines before the liver biopsy, and might even ask you to fast for eight hours before the procedure. A liver biopsy not only detects autoimmune hepatitis, but also determines whether cirrhosis (scarring of the liver) is present.
Treatment
The main target of the treatment is to prevent the immune system from attacking the liver. Treatments will also help slow down the development of the disease. If the disease becomes serious, your doctor may prescribe "prednisone." Corticosteroids, which are most commonly in the form of prednisone, can be used to reduce and treat swelling of the liver. However, prednisone has some side effects. For this reason, your doctor will reduce the dose slowly. Adding azathioprine also helps you to stay away from the side effects of prednisone. It is required to continue the medicine for at least 18 to 24 months. Liver transplantation is the last remaining option if the disease leads to cirrhosis.
Drugs and Medication
If you do not have severe autoimmune hepatitis, then you can survive on medications and lead a normal life. Immunosuppressant drugs are prescribed to prevent the immune system’s attack. The immune system is the one who mistakenly attacks the liver, causing damage. Drugs include 6-mercaptopurine and azathioprine. Since immunosuppressant drugs suppress the immune system, using them might decrease your body's ability to fight off other infections.
Surgery
A liver transplant is required when autoimmune hepatitis becomes way too serious. It is used only when the medications have stopped working. At this point, the liver would have been completely damaged.
Life Expectancy for Autoimmune Hepatitis
The life expectancy of people with autoimmune hepatitis can vary from person-to-person. Autoimmune hepatitis causes damage to the liver when the immune system attacks it. The condition can be treated properly with drugs and medication. It also depends on the condition of the liver, which is determined through liver function tests. Those reacting well to medication live on for years and years.
Overall, research has shown that the life expectancy of people who are diagnosed with autoimmune hepatitis is the same as the ones who do not have it. However, for those individuals who do not wish to get treated, they can develop liver failure and ultimately need a liver transplantation.
Complications of Autoimmune Hepatitis
Potential complications of untreated autoimmune hepatitis include:
- Liver failure
- Scarring of the liver
- Liver cancer
- Increased blood pressure in the portal vein (the vein that supplies blood to the liver)
- Enlarged veins in your stomach and esophagus
- Fluid accumulation in the abdomen
