Autoimmune Hepatitis Causes Cirrhosis of the Liver
What Is Autoimmune Hepatitis?
Autoimmune hepatitis is a disease that can be mild or very serious as it causes inflammation of the liver.
Type 1 autoimmune hepatitis is the most common type found in North America, affecting approximately one in every 235,294 people, and it is more common in women. Quite often it occurs in adolescence or your adulthood, but may occur at any age.
Approximately one half of the people that have this disease also have another autoimmune disease. Type II is rare and usually affects females between two and fourteen.
What Causes Autoimmune Hepatitis?
No one knows why the liver is targeted by the immune system. Somehow, the body no longer recognizes the differences between invading bacteria and viruses and its own cells.
Some physicians think there is a genetic component for some patients. It is a type of chronic hepatitis that leads to progressive liver damage, and in 10–20 percent of the cases, it acts like acute hepatitis.
Sometimes, autoimmune hepatitis is caused by a particular medication, and other times, it is simply an autoimmune disease without a definitive cause.
Liver Disease Symptoms
There are several typical symptoms that are common with this disease. These symptoms include:
- Fatigue – most common complaint
- Skin rashes
- Joint pain
- Abdominal discomfort
- Spider angiomas and other blood vessel abnormalities on the skin
- Enlarged liver
- Pale or gray-colored stools
- Appetite loss
- Dark urine
- Ascites – fluid collected in the abdomen
In advanced liver disease, ascites—fluid that collects in the abdomen—is also common. This may cause mental confusion as well. In addition, menstrual symptoms stop for women.
Autoimmune Hepatitis: A Rare Condition With Serious Consequences
Diagnosis of Liver Disease
The diagnostic process for hepatic diseases includes a number of blood tests and other types of tests depending on the degree of illness. The primary blood test is the Anti-Smooth Muscle Antibody (ASMA), which is a specific test for autoimmune hepatitis as it detects antibodies that attack smooth muscles.
Muscles are made up of myosin II, which are heavy chains of long fibers, and actin, which are thinner filaments, important for contractile movement. The actin is the fiber being attacked in this autoimmune disorder.
Striated muscles are found in the long muscle of the arms and legs. Smooth muscles are found in the organs of the body, such as in the gastrointestinal tract, blood vessel walls and many other places. When the antibodies that attack smooth muscles are present, they cause inflammation, which is destructive.
There are other blood tests that will be evaluated, such as liver enzyme tests, the AMA test which looks a smooth body antibodies, an ANA, ALT, and SMA to look at inflammation and liver function. Liver biopsies are done for the more severe cases.
If antibodies attack the liver and the patient does not receive any medical treatment, they will get cirrhosis of the liver, and eventually have complete liver failure.
No medications are available as a cure, but treatment is focused on slowing the disease progress. With treatment approximately seven out of 10 people will go into a remission within two years of beginning treatment.
It is quite common for patients to need treatment off and on through the years once they receive this diagnosis.
- Corticosteroid medication in the form of prednisone is a common treatment, and it starts at a high dosage initially. Then, it is reduced to the lowest dosage that will still treat the disease. The average patient will require 18 to 24 months of this treatment.
- Azathioprine (Azusa, Imuran) is also an immunosuppressant medication that is sometimes given in conjunction with prednisone. Taking this medication suppresses the immune system, so infections can become a problem.
- Other immunosuppressants may be used if the others listed above are ineffective. They include CellCept, cyclosporines or Prograf.
If these medications do not work, the patient will need a liver transplant.
Symptoms of this disease will often lessen over the years with medical treatment as seven out of 10 people go into remission; however, the disease usually reoccurs throughout their lifetime, and treatment will begin again.
The prognosis for individuals is not easy as all people do not respond in the same way to the same treatments. Remember that prognosis is only a medical opinion, not a fact.
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© 2013 Pamela Oglesby