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Autoimmune Hepatitis Causes Cirrhosis of the Liver

Cirrhosis of the liver

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. It often occurs in adolescence or 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, 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.

Risk factors and symptoms of hepatitis

Risk factors and symptoms of hepatitis

Liver Disease Symptoms

There are several typical symptoms of this disease, including:

  • Fatigue – most common complaint
  • Skin rashes
  • Joint pain
  • Abdominal discomfort
  • Spider angiomas and other blood vessel abnormalities on the skin
  • Enlarged liver
  • Jaundice
  • Pale or gray-colored stools
  • Nausea
  • Vomiting
  • Appetite loss
  • Dark urine
  • Itching
  • 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.

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 at 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.

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No medications are available as a cure, but treatment is focused on slowing the disease's progression. With treatment, approximately seven out of 10 people will go into 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.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.


Pamela Oglesby (author) from Sunny Florida on April 10, 2020:

Hi Peggy,

This can be a tough disease but at least a period of remission is possible. I appreciate your comments.

Peggy Woods from Houston, Texas on April 10, 2020:

You continually shed light on some of the diseases and afflictions that affect some people. It is good to know that with the proper treatment, often a period of remission takes place.

Pamela Oglesby (author) from Sunny Florida on June 27, 2013:

Patircia, It is certainly not a good disease to have and I am sorry to hear your uncle suffered with it. Thanks for the comments ane I love the angels. More are sent back to you also! Have a wonderful day.

Patricia Scott from North Central Florida on June 27, 2013:

I know a little about this condition as I had an Uncle who suffered from it. But I was a week bit of a girl and really did not know the full story. Your detailed explanation has now cleared up some of the questions I had.

Angels are winging their way to you this morning, Pamela. ps

Pamela Oglesby (author) from Sunny Florida on June 05, 2013:

drbj, My Merck Manual is collecting dust. :) I'm sure your are quite well informed. Thanks for your comments.

drbj and sherry from south Florida on June 05, 2013:

Very thorough and informative, Pam. Now I don't have to rely only on my Merck's Manual any more. ;)

Pamela Oglesby (author) from Sunny Florida on June 05, 2013:

starbright, It is a bit scary, but being informed I think is good. That way if you or a loved one gets some strange symptoms you will know that you need medical treatment.. Thanks for your comments.

Lucy Jones from Scandinavia on June 05, 2013:

Very interesting and informative hub - bit scary though. Thanks for sharing your invaluable insight. Voted up.

Pamela Oglesby (author) from Sunny Florida on June 05, 2013:

dilpchandra, I am glad you found the hub interesting and your comments are appreciated.

Dilip Chandra from India on June 04, 2013:

Very well written hub, it is informative.

Pamela Oglesby (author) from Sunny Florida on June 04, 2013:

Nell Rose, There are about four types of hepatitis, but the symptoms are the same. I am glad you enjoyed the hub and appreciate your comments.

Pamela Oglesby (author) from Sunny Florida on June 04, 2013:

Ruby, It is always interesting to write the medical hubs as invariably someone will have the disease or know someone with the symtptoms. Thanks so much for your comments.

Pamela Oglesby (author) from Sunny Florida on June 04, 2013:

Sue, I hope she doesn't have this disease, but I am glad you have this information. Thanks for your comment.

Pamela Oglesby (author) from Sunny Florida on June 04, 2013:

Faith, I am glad you found the hub insightyful. I appreciate your comments and the share.

Nell Rose from England on June 04, 2013:

Hi Pamela, I remember a friend having Hepatitis, she never went into detail so I am not sure how she got it, but this goes a long way to explaining it properly for me so thank you, fascinating hub, and voted up and shared! nell

Ruby Jean Richert from Southern Illinois on June 04, 2013:

Interesting and useful info. Pam. Thank you for all of your informative hubs on diseases and treatments..

Susan Bailey from South Yorkshire, UK on June 04, 2013:

I am going to show this to a friend. Her symptoms sound pretty much like these.

Faith Reaper from southern USA on June 04, 2013:

Hi Pamela,

Very interesting article. I was not aware that the liver could be affected by autoimmune diseases.

Thanks so much for this insightful piece here.

Voted up ++ and sharing

God bless, Faith Reaper

Pamela Oglesby (author) from Sunny Florida on June 04, 2013:

bassia, I appreciate your comments.

Pamela Oglesby (author) from Sunny Florida on June 04, 2013:

Molly, It is always good to be informed and with the vareity of autoimmune diseases out there, most any organ can be affected. It would be nice if scientist would come up with some cures. I appreciate your comments.

bassia on June 04, 2013:

thank you for the information .I really appreciate it.

Mary Strain from The Shire on June 04, 2013:

I knew about many autoimmune diseases, but not that the liver could be affected. Thanks for the heads up!

Rebecca Mealey from Northeastern Georgia, USA on June 04, 2013:

Scary stuff. Thanks for keeping us in the loop on this disease. Even though there is no cure, I am glad that it can be held at bay.

Bill Holland from Olympia, WA on June 04, 2013:

I've had a few friends in AA die of cirrhosis of the liver....not a pretty sight to see. Thank you for this valuable and important information.

Pamela Oglesby (author) from Sunny Florida on June 04, 2013:

Wayne, That is so true. Autoimmune diseases seem to be one of the hardest types of disease to cure and they only treat symptoms in most cases. That means so cure. I wish you good health in the future. I have great hope for stem cell cures, but that takes time. Thanks so much for your comments.

Wayne Brown from Texas on June 04, 2013:

Interesting...I knew of two types of Hepatitis but did not know that it could develop as a result of the body just turning on itself. It has many characteristics of Type I Diabetes in that the immune system basically destroys the pancreas' ability to produce ilet cells to balance blood glucose in the body...we don't know what causes that either. As smart as we are...we have a long way to go to understand all the pathways in the human body. Good reading, Pam...thanks for sharing it. ~WB

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