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New Delhi, July 27,2018 :
What is Autoimmune Hepatitis?
The liver is one of the largest and most important organs in the body. The primary functions of liver are to cleanse toxins from the blood, aids in the digestion process, break down medications and prevents blood clotting.
Autoimmune hepatitis is a disease characterized by chronic inflammation of the liver of unknown cause. In this disease there is failure of immune tolerance leading to immune attack against the liver cells.
What is the cause of Autoimmune Hepatitis?
The exact cause why our own immune system attacks the liver cells is unknown. However it appears that certain types of white blood cells misinterpret liver cells as foreign substances and start attacking these cells leading to the inflammation in the liver.
What are the types of Autoimmune Hepatitis?
There are two types of AIH described in literature
Type 1 (classic): This is the most common type of the disease. It can occur at any age and is more common in females. It is also associated with other autoimmune disorders, such as thyroiditis, rheumatoid arthritis or ulcerative colitis in about one third of patients.
Type 2 AIH: Although adults can develop type 2 autoimmune hepatitis, it is most common in young girls and often occurs with other autoimmune problems. It is usually more severe and can present with advanced liver disease at the onset of symptoms
What are the risk factors?
Below are some factors that may increase the risk of autoimmune hepatitis:
- History of infections: Autoimmune hepatitis may develop in case the patient has history of infections such as measles, herpes simplex or Epstein-Barr virus. Hepatitis A, B or C infection are also liked with this disease.
- Heredity. In some cases the disease was seen to run in families. This suggests that heredity is one of the factors related to autoimmune hepatitis.
- Gender: Although both men and women are can develop autoimmune hepatitis at any stage, women are more prone to this disease.
What are the symptoms of Autoimmune Hepatitis?
The initial symptoms are nonspecific symptoms such as fatigue, jaundice, nausea, abdominal pain, and arthralgias, but the clinical spectrum is wide, ranging from an asymptomatic presentation to an acute severe disease. In many patients there will be no symptoms at all and the condition is diagnosed on a routine liver function tests by an elevation in levels of liver enzymes.
What are the tests useful for diagnosis of Autoimmune Hepatitis?
Blood tests will almost always reveal elevations of certain liver enzymes that are synthesized by the liver. In addition, other blood tests will reveal antibodies such as anti-smooth muscle antibody and antinuclear factor antibody and anti LKM antibody. The levels of immunoglobulin G may be elevated in the blood. Finally, a liver biopsy is required to confirm the diagnosis.
What is the treatment for Autoimmune Hepatitis?
Autoimmune hepatitis is one of the few liver diseases with excellent response to therapy. Corticosteroids are the mainstay of treatment and are used as first line drugs. These drugs will reduce inflammation in the liver. In addition to, or in place of corticosteroids, other drugs with anti-inflammatory activity, such as azathioprine, mycophenolate mofetil, methotrexate or tacrolimus may also be used. However some patients with very mild or inactive disease may not need any type of active treatment and require close follow up.
Untreated autoimmune hepatitis can lead to scarring of the liver and ultimately results in cirrhosis and liver failure. However, early intervention and proper treatment can prevent scarring and cirrhosis in most patients. Treatment is possible at any stage like advanced scarring or when cirrhosis has already developed, progression of scarring and, in some cases, reversing the scarring.
What lifestyle changes one can follow?
Alcohol should completely be avoided since it can severely damage the liver. Even a little amount alcoholic be of Patients with liver disease may worsen with even small amounts of alcohol.
It is recommended that the patient must eat a normal, healthy and balanced diet. Do regular low intensity workout to avoid becoming obese as obesity can increase the risk of fatty liver disease and may complicate autoimmune hepatitis.
The patient must see a doctor on a regular basis and should take only prescribed medication to ensure that the liver remains as healthy as possible and to avoid any further complications.
Dr. Abhideep Chaudhary,
Senior Consultant,
Liver Transplant Department,
Jaypee Hospital, Noida
HealthySoch
