Health Encyclopedia

Autoimmune Hepatitis

What is autoimmune hepatitis?

Autoimmune hepatitis is when your body’s infection-fighting system (immune system) attacks your liver cells. This causes redness and swelling (inflammation) and liver damage.

It is a long-term or chronic inflammatory liver disease.

Autoimmune hepatitis may be classified as type 1 or type 2.

Type 1 or classic

  • Is the most common form of the disease
  • May occur at any age but usually starts when you are a teen or young adult
  • Affects women more than men
  • Is often linked with other diseases where the body attacks itself (autoimmune disorders). These may include thyroiditis, Grave's disease, type 1 diabetes, and ulcerative colitis.

Type 2

  • Is less common
  • Most often affects girls between the ages of 2 and 14 years old

The liver is a large organ that lies up under your ribs on the right side of your belly or abdomen. It helps filter waste from your body, makes bile to help digest food, and stores sugar that your body uses for energy.

What causes autoimmune hepatitis?

Experts don’t know what causes autoimmune hepatitis.

It is linked to a disorder called hypergammaglobulinemia. This disorder occurs when you have too many protein antibodies in your blood. It may be caused by a long-term (chronic) infection or certain blood diseases.

Type 1 autoimmune hepatitis is linked with other disorders where the body attacks itself (autoimmune disorders). These may include thyroiditis, Grave's disease, type 1 diabetes, and ulcerative colitis.

What are the symptoms of autoimmune hepatitis?

Each person’s symptoms may vary. Some of the most common symptoms may include:

  • Extreme tiredness (fatigue)
  • Yellowing of the skin and eyes (jaundice)
  • Belly or abdominal pain
  • Joint pain or swelling
  • Mild flu-like symptoms
  • Itching
  • Large abdomen due to large liver and spleen
  • Spider-like blood vessels in the skin

Other autoimmune hepatitis symptoms may include:

  • Dark urine
  • Pale or gray-colored stools
  • Women stop having menstrual periods
  • Loss of appetite
  • Fluid buildup in the belly or abdomen (ascites)
  • Confusion

The symptoms of autoimmune hepatitis may look like other health problems. Always see your health care provider to be sure.

How is autoimmune hepatitis diagnosed?

Your health care provider will look at your past health and give you a physical exam.

Some lab blood tests used to diagnose autoimmune hepatitis include:

  • Liver function tests. These check for any redness and swelling (inflammation) or damage to your liver.
  • Complete blood count or CBC. Looks at the number and types of cells in your blood.
  • Bleeding time. Looks at how fast the small blood vessels in your skin close to stop you from bleeding.
  • Electrolyte panel. Checks to see if you have too many or too few minerals (electrolyte imbalance) in your blood.
  • Autoimmune antibodies. These are used to see if you have autoimmune hepatitis or another liver disease with similar symptoms.
  • Tests for other chemicals in your body.

You may also have imaging tests such as:

  • CT scan (computed tomography). A CT scan is more detailed than a standard X-ray. It can show detailed images of any part of the body, including the bones, muscles, fat, and organs. It uses both X-rays and computer technology to make horizontal images (often called slices) of the body.
  • MRI (magnetic resonance imaging). This test makes detailed pictures of organs and structures inside your body. It uses a magnetic field and pulses of radio wave energy. A dye may be shot or injected into your vein. The dye helps the liver and other organs in the belly to be seen more clearly on the scan.
  • Liver biopsy. Small tissue samples are taken from your liver with a needle. These samples are checked under a microscope to find out the type of liver disease.

How is autoimmune hepatitis treated?

Treatment works best when autoimmune hepatitis is found early. The goal of treatment is to control the disease and to reduce or get rid of any symptoms(be in remission).

To do this, medicines (corticosteroids and immune system suppressors) are used to help slow down or suppress your over-active immune system. They also stop your body from attacking your liver.

Once you have started treatment, it can take 6 months to a few years for the disease to go into remission. Some people can stop taking medicine, but often the disease comes back. You may need on-and-off treatment for the rest of your life.

In some cases autoimmune hepatitis may go away without taking any medicines. But for most people autoimmune hepatitis is a chronic disease.

It can lead to scarring of the liver (cirrhosis). The liver can become so badly damaged that it no longer works. This is called liver failure.

If you have liver failure, a liver transplant may be needed.

Key points about autoimmune hepatitis

  • Autoimmune hepatitis is when your body's infection-fighting system (immune system) attacks your liver cells.
  • It is a long-term chronic liver disease that causes redness and swelling (inflammation) and liver damage.
  • Experts don’t know what causes it.
  • It affects more women than men.
  • Medicines are often used to control the disease.
  • It can lead to scarring of the liver (cirrhosis) and liver failure.

Next steps

Tips to help you get the most from a visit to your health care provider:
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Medical Reviewers:

  • Sohrabi, Farrokh, MD
  • Stump-Sutliff, Kimberly, RN, MSN, AOCNS