Autoimmune hepatitis is a liver disease caused by a chronic immune-related inflammation of liver tissue. The long-term damage to the liver tissue is followed by gradual impairment of liver functions. Autoimmune hepatitis belongs to a group of illnesses known as autoimmune diseases.
Autoimmune hepatitis is a classic autoimmune disorder. Our own immune system begins to malfunction and initiate a formation of antibodies targeted against our own tissues (so called autoantibodies). In this case liver cells are the victims. Why this situation occurs is not clear, but presumably there is a combination of certain genetic predisposition and impact of certain external factors (possibly some viral infections). The disease occurs by both male and female sex but there is a clear female predominance.
Immune system damages liver cells and causes a chronic liver inflammation. The general course of the disease is variable. Sometimes it manifests as an acute hepatitis with significant symptoms (jaundice, weakness, loss of appetite, liver enlargement, a sharp increase in liver tests etc.) following by an acute liver failure.
Other times, the disease continues quietly and insidiously as a chronic inflammation that has minimal symptoms. Such long-term course of autoimmune hepatitis gradually leads to severe liver damage and liver cirrhosis with all its complications (liver failure, portal hypertension, hepatic encephalopathy, liver cancer etc.).
Personal history and physical examination should as always come. It is essential to know in particular about a known autoimmune disease in family history, about patient’s present medication and his or her attitude to alcohol.
Performing blood tests we are interested mostly in liver tests levels. Imaging methods are used to examine liver tissue. Abdominal ultrasound is most common and cheap way to image both the anatomy of liver and biliary tree. If there is a suspicion of autoimmune hepatitis, it is important to perform a special examination for presence of certain autoantibodies (for example ANA, ASMA or ANCA antibodies) and execute a liver biopsy to obtain its tissue sample for histological examination.
The disease is incurable but can be treated by different drugs suppressing the immune system. If cirrhosis and other complications occur, we try to treat them (visit relevant articles for more information). When there is a severe hepatic impairment present, a liver transplant may be the ultimate choice.