Autoimmune hepatitis

Alternative names

Lupoid hepatitis

Definition

Autoimmune hepatitis involves inflammation of the liver caused by rogue immune cells that mistake the liver's normal cells for a foreign tissue or pathogen (disease-causing agent).

Causes, incidence, and risk factors

A person with autoimmune hepatitis has autoantibodies circulating in the bloodstream that cause the immune system to attack the liver.

This disease is associated with other autoimmune diseases, including the following:

• Thyroiditis
  
• Type 1 diabetes
  
• Ulcerative colitis
  
• Hemolytic anemia
  
• Proliferative glomerulonephritis
  

Autoimmune hepatitis sometimes occurs in relatives of people with autoimmune diseases, suggesting a genetic cause.

This disease is most common in young girls and women.

Symptoms

• Dark urine
  
• Loss of appetite
  
• Fatigue
  
• General discomfort, uneasiness, or ill feeling (malaise)
  
• Abdominal distention
  
• Generalized itching
  
• Pale or clay-colored stools
  
• Nausea and vomiting
  

Additional symptoms that may be associated with this disease include amenorrhea (absence of menstruation).

Signs and tests

• Liver biopsy showing chronic hepatitis
  
• Abnormal liver function tests
  

Tests associated with autoimmune hepatitis:

• Positive ANA
  
• Positive anti-smooth muscle antibody
  
• Positive anti-liver kidney microsomal antibody
  
• Positive anti-mitochondrial antibody
  
• Elevated sedimentation rate
  
• Elevated serum IgG
  

Treatment

Prednisone or other corticosteroids help reduce the inflammation. Azathioprine or mercaptopurine are drugs used to treat other autoimmune disorders, and they have benefitted patients with autoimmune hepatitis as well.