Autoimmune Hepatitis

Autoimmune hepatitis is the type of hepatitis that occurs when your own immune system - which normally protects you from attack by germs and foreign substances - mistakenly targets your liver like a potentially harmful invader.

Hepatitis is a liver disorder that occurs when the liver becomes inflamed due to one of several causes.

If autoimmune hepatitis goes untreated, it can result in serious liver damage from scarring (known as cirrhosis). This may eventually lead to liver failure, requiring a liver transplant.

Causes of autoimmune hepatitis are unclear. But there's some evidence that autoimmune hepatitis may be triggered by certain infections, diseases, toxins, or drugs. Certain individuals may have a genetic predisposition.

Autoimmune hepatitis sometimes follows a hepatitis C infection. This can be especially harmful to liver cells, which are not only damaged by hepatitis C but are also damaged by attack from the immune system.

Autoimmune hepatitis often occurs at the same time as other disorders that are not related to the liver, including diabetes, kidney problems, ulcerative colitis, anemia and thyroiditis.

Two main types have been described by medical researchers.

Type 1 This type of autoimmune hepatitis.is the most common. It happens to people of all ages, and approximately 50 percent have other autoimmune disorders.

Type 2 happens more frequently to young girls in conjunction with other autoimmune problems.

Symptoms of autoimmune hepatitis

Symptoms are similar to other forms of hepatitis.

• abdomen pain
• enlarged liver 
• fatigue
• itchy skin
• jaundice 
• joint pain
• light colored stools (often described as "clay-colored")
• nausea and vomiting
• urine that is darker than usual

Symptoms may be mild or severe. They may occur rapidly or develop over time.

Treatment

The purpose of treatment is to slow down or even stop your immune system from attacking your liver. This is done through the use of immunosupressant medications, including the following.

Prednisone. This is a corticosteroid drug, which is a class of drugs designed to fight inflammation. Your doctor will usually start with a high dose of prednisome and reduce the dose as symptoms improve. Some people with autoimmune hepatitis have to keep taking it for life, while others may be able to stop after remission has been attained.

While prednisone can be effective, it often causes serious side effects when taken long term. Some of these side effects can be serious, including diabetes, glaucoma, high blood pressure, osteonecrosis, osteoporosis, and weight gain.

Azathioprine, which is also known as Imuran. This is also an immunosuppressant, and it can be used in conjunction with prednisone to help keep side effects of prednisone to a minimum. Azathioprine can also have some serious side effects, but they are rare. They include nausea, difficulty dealing with infections, pancreatitis and cancer.

Cyclosporine or tacrolimus. These are more powerful immunosupressants, which your doctor may recommend if prednisone and azathioprine are not effective.

A liver transplant is the last option. This is done only when medications have failed or damage has been so severe that the liver has failed. 

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