Autoimmune hepatitis (patient information)

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Autoimmune hepatitis

Overview

What are the symptoms?

What are the causes?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

Overview

Autoimmune hepatitis is a chronic—or long-lasting disease in which the body's immune system attacks the normal components, or cells, of the liver and causes inflammation and liver damage. The immune system normally protects people from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. Autoimmune hepatitis is a serious condition that may worsen over time if not treated. Autoimmune hepatitis can lead to cirrhosis and liver failure. Cirrhosis occurs when scar tissue replaces healthy liver tissue and blocks the normal flow of blood through the liver. Liver failure occurs when the liver stops working properly

What are the symptoms of Autoimmune hepatitis?

The most common symptoms of autoimmune hepatitis are:

  • Fatigue
  • Joint pain
  • Nausea
  • Loss of appetite
  • Pain or discomfort over the liver
  • Skin Rashes
  • Dark yellow urine
  • Light-colored stools
  • Jaundice, or yellowing of the skin and whites of the eyes

Symptoms of autoimmune hepatitis range from mild to severe. Some people may feel as if they have a mild case of the flu. Others may have no symptoms when a health care provider diagnoses the disease; however, they can develop symptoms later.

What are the causes?

A combination of autoimmunity, environmental triggers, and a genetic predisposition can lead to autoimmune hepatitis.

When to seek urgent medical care?

Diagnosis

  • A health care provider will make a diagnosis of autoimmune hepatitis based on symptoms, a physical exam, blood tests, and a liver biopsy.
  • A health care provider performs a physical exam and reviews the person's health history, including the use of alcohol and medications that can harm the liver. A person usually needs blood tests for an exact diagnosis because a person with autoimmune hepatitis can have the same symptoms as those of other liver diseases or metabolic disorders.

Blood tests A blood test involves drawing blood at a health care provider's office or a commercial facility and sending the sample to a lab for analysis. A person will need blood tests for autoantibodies to help distinguish autoimmune hepatitis from other liver diseases that have similar symptoms, such as viral hepatitis, primary biliary cirrhosis, steatohepatitis, or Wilson disease.

Liver biopsy

  • A liver biopsy is a procedure that involves taking a piece of liver tissue for examination with a microscope for signs of damage or disease. The healthcare provider may ask the patient to temporarily stop taking certain medications before the liver biopsy. He or she may also ask the patient to fast for 8 hours before the procedure.
  • During the procedure, the patient lies on a table, right hand resting on the head. A health care provider will apply a local anesthetic to the area where he or she will insert the biopsy needle. *If needed, he or she will give sedatives and pain medication. Then, he or she will use a needle to take a small piece of liver tissue and may use ultrasound, computerized tomography scans, or other imaging techniques to guide the needle. After the biopsy, the patient must lie on the right side for up to 2 hours and is monitored an additional 2 to 4 hours before being sent home.
  • A health care provider performs a liver biopsy at a hospital or an outpatient center. The liver sample is sent to a pathology lab where the pathologist—a doctor who specializes in diagnosing disease—looks at the tissue with a microscope and sends a report to the patient's health care provider.
  • A health care provider can use the liver biopsy to diagnose autoimmune hepatitis and determine if cirrhosis is present. People often have cirrhosis at the time they are diagnosed with autoimmune hepatitis. A health care provider can also use liver biopsy to look for changes in the severity of liver damage prior to ending treatment for autoimmune hepatitis

Treatment options

Medications to avoid

Where to find medical care for autoimmune hepatitis?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

Sources