Autoimmune Hepatitis causes chronic inflammation in the liver, similar to other types of hepatitis. However, instead of a virus or alcohol causing damage to your liver, it is your immune system that attacks it. This disease has no cure, but it can be managed with medications. In this article presented by Dr. Mohamed Al Boraie, we will learn about the symptoms of autoimmune hepatitis, its diagnosis, and treatment duration.
What is Autoimmune Hepatitis?
Autoimmune Hepatitis is a chronic liver disease that starts with an error in your immune system. The immune system sends antibodies to attack healthy liver tissues, causing inflammation in the liver.
Autoimmune Hepatitis causes chronic inflammation in the liver, which can lead to severe damage over time. Like other types of chronic hepatitis, It can lead to liver tissue scarring. Medical treatment helps reduce inflammation and prevent complications.
Types of Autoimmune Hepatitis
Type 1 Autoimmune Hepatitis:
- Common and can occur at any age.
- Half of those affected may have other immune disorders like rheumatoid arthritis and ulcerative colitis.
Type 2 Autoimmune Hepatitis:
- More common in children and young adults.
- May also occur in adults but less frequently.
- Associated with other immune-related diseases.
Symptoms of Autoimmune Hepatitis
Some common early symptoms include:
- Abdominal pain or discomfort.
- Abdominal swelling with liver enlargement.
- Fatigue.
- Joint pain.
- Skin rash.
- Acne.
As liver function deteriorates, symptoms may progress to:
- Jaundice (yellowing of the skin and eyes).
- Dark-colored urine and pale-colored stool.
- Itching of the skin.
- Nausea and loss of appetite.
Late-stage symptoms may include:
- Enlarged veins in the esophagus leading to varices.
- Easy bruising and bleeding.
- Accumulation of fluid in the abdomen (ascites) or hands and feet.
Causes of Autoimmune Hepatitis
Autoimmune diseases occur when the immune system mistakenly considers certain cells as threats and continues attacking them, causing chronic inflammation in certain parts of the body. Your immune system sends specific antibodies to attack certain liver cells.
Viruses that can cause Autoimmune Hepatitis
Medications that can cause Autoimmune Hepatitis
- Nitrofurantoin (for urinary tract infections).
- Minocycline (for acne).
- Atorvastatin (for high cholesterol).
- Isoniazid (an antibiotic).
Other Autoimmune Diseases associated
Some individuals may have hepatitis along with another autoimmune disease affecting the bile ducts, such as:
- Primary Biliary Cholangitis (PBC).
- Primary Sclerosing Cholangitis (PSC).
Any pre-existing autoimmune disease may make you more susceptible to another disease. The chance of developing a second autoimmune disease is 25%-50%. If the hepatitis is the first autoimmune disease, there is a chance of developing a second one. Other common conditions associated with hepatitis include inflammatory bowel disease, rheumatoid arthritis, type 1 diabetes, and vitiligo.
Diagnosis of Autoimmune Hepatitis
The doctor begins with a physical examination and routine tests, including imaging and blood tests, to detect liver inflammation.
Additional blood tests are performed to check for specific viruses, autoantibodies, and other causes of liver inflammation.
After ruling out other causes and identifying antibodies associated with hepatitis, the diagnosis can be confirmed by taking a liver biopsy.
Treatment of Autoimmune Hepatitis:
High doses of corticosteroids may be prescribed to reduce inflammation and suppress the autoimmune response. Prednisone is the most prescribed medication for treating autoimmune hepatitis, but it can have side effects. It may be replaced with budesonide.
The doctor may prescribe an immunosuppressive drug called azathioprine along with steroids or after completing the steroid course. Azathioprine has fewer side effects than steroids and works better for long-term control of the immune system.
Side effects of immunosuppressive drugs may include:
- Recurrent infections.
- Vomiting and nausea.
- Skin rash.
- Easy bruising and bleeding.
- Kidney function impairment.
- Pancreatitis.
Duration of Autoimmune Hepatitis Treatment:
The goal of medications is to calm the immune system. You may need to take immunosuppressive drugs for several months or years until liver enzyme levels gradually return to normal.
While some people improve with treatment, others may not respond at all, and they may develop complications requiring additional treatment or liver transplantation.
Can Autoimmune Hepatitis be Cured?
Inflammation may disappear for some time, but after stopping treatment, it can return, known as a relapse.
Best Doctor for Autoimmune Hepatitis Treatment
Dr. Mohamed Al Boraie is considered the best doctor for treating autoimmune hepatitis. He is a liver and gastrointestinal endoscopy consultant, a Fellow of the Royal College of Physicians in England, and a member of the American College of Gastroenterology. Currently, Dr. Mohamed Al Boraie is a lecturer in internal medicine, liver, and gastrointestinal endoscopy at Al-Azhar University in Cairo.
Dr. Mohamed Al Boraie participates in numerous local and international scientific conferences regularly and has many scientific research papers published in prestigious medical journals.
Book your appointment now if you want to consult with Dr. Mohamed Al Boraie regarding the treatment of autoimmune hepatitis and other acute and chronic liver diseases.