What is autoimmune hepatitis?

The article is expertly consulted by a Doctor of Gastrointestinal Endoscopy - Department of Medical Examination & Internal Medicine - Vinmec Da Nang International General Hospital.

Autoimmune hepatitis is inflammation of the liver that occurs when the body's immune system fights off liver cells. The exact cause of autoimmune hepatitis is currently unknown, but it is possible that genetic and environmental factors interact with the body over time in triggering the disease. Untreated autoimmune hepatitis can lead to cirrhosis and eventually liver failure. However, when diagnosed and treated early, autoimmune hepatitis can often be controlled with medications that suppress the immune system.

There are two types of autoimmune hepatitis, and both are rare. Type 1 is more common, usually seen in women aged 15 to 40 years, although any age or gender can get type 1 autoimmune hepatitis. Type 2 usually occurs with autoimmune hepatitis in children female from 2 to 14 years old.
If you have autoimmune hepatitis, you most likely also have another autoimmune disease, such as Crohn's disease, rheumatoid arthritis, lupus, or Sjogren's syndrome.

Studies done in the Nordic countries have found that between 10 and 24 out of every 100,000 people in this region have autoimmune hepatitis. Researchers have found that the disease is more common in Alaskan natives, affecting about 43 per 100,000 people.

Autoimmune hepatitis can occur at any age and affects people of all races and ethnicities. The disease is more common in girls and women than in boys and men. Type 1 autoimmune hepatitis occurs in people of all ages, while type 2 usually affects children.

Autoimmune hepatitis occurs when the body's immune system does not attack viruses, bacteria, and other pathogens, but instead targets liver cells. Attacking the liver can lead to chronic inflammation and serious damage to liver cells.
Currently, scientists do not know the exact cause of the body's immune system turning against itself, but some researchers think that autoimmune hepatitis may be caused by the interaction of genes that control immune system function and exposure to viruses or certain drugs such as:
Drugs such as statins and hydralazine (used to treat disease) heart) or antibiotics such as nitrofurantoin and minocycline Stress Infections such as viral hepatitis, herpes virus, Epstein-Barr virus, and measles virus

Factors that may increase the risk of autoimmune hepatitis include:
Being female. Although both men and women can get autoimmune hepatitis, the disease is more common in women. History of infection. Autoimmune hepatitis can develop after a person is infected with measles, herpes simplex, or the Epstein-Barr virus. The disease is also linked to hepatitis A, B or C infection. Genetics. Some evidence suggests that autoimmune hepatitis tends to run in families. Have another autoimmune disease. People who already have an autoimmune disease, such as celiac disease, rheumatoid arthritis, or hyperthyroidism, may all be susceptible to autoimmune hepatitis.

The disease has a silent onset, with only a slight feeling of fatigue and malaise combined with mild jaundice over a long period of several months to several years; Only a small number (about 25%) have a presentation presenting as acute viral hepatitis. The disease is of real concern only when jaundice becomes apparent and a diagnosis is made. Dysmenorrhoea is a common and highly suggestive symptom, usually with the loss of one or two menstrual cycles and this co-occurring with a severe episode of jaundice.
Nosebleeds, bleeding gums and bleeding under the skin are also common manifestations.
When examining the abdomen, it can be seen that the liver is enlarged and the left lobe is usually larger, however, it is an early stage, and in the late stage, the liver is often atrophy and has manifestations of portal hypertension such as spleen enlargement, ascites, collateral circulation.
However, it is important to watch out for other associated manifestations:
Skin changes, allergic capillary inflammation, acne, erythema or scattered erythema. The spleen is enlarged and often accompanied by lymphadenopathy. Endocrine disorders with many manifestations of acne, hirsutism and cracked skin, in men also have manifestations such as breast enlargement, autoimmune thyroiditis, thyrotoxicosis, diabetes. Ulcerative colitis may occur concurrently with or after the onset of autoimmune hepatitis. In addition, there are many other accompanying manifestations such as glomerulonephritis, pleural effusion, atelectasis, alveolar fibrosis, chronic anemia and frequent infections.

Untreated autoimmune hepatitis can cause permanent scarring of liver tissue (cirrhosis). Complications of cirrhosis include:
Esophageal varices. When circulation through the portal vein is blocked, blood can back up into other blood vessels - mainly in the stomach and esophagus. Blood vessels have thin walls, and because they hold more blood than they can hold, they are more likely to burst and bleed. Massive bleeding in the esophagus or stomach from these blood vessels is a life-threatening emergency that requires immediate medical attention. In cirrhosis of the liver ascites (the final stage of cirrhosis), the liver is no longer able to repair itself and gradually loses its function. At this time, the disease was very serious, progressing quite complicatedly in a bad direction. At that time, the liver cannot perform the detoxification function, from which the whole body will be poisoned. Liver failure. This occurs when the liver cells are damaged in such a way that the liver cannot function properly. At this point, the patient needed a liver transplant. Liver Cancer . People with cirrhosis have an increased risk of liver cancer. Screening for liver cancer every 6 months is one of the ways to detect the disease early, even when there are no symptoms. Where to screen for liver cancer to give accurate results is a matter of concern for many people.
>> See more: Test to identify 14 autoantibodies in autoimmune liver disease - Article by Master, Doctor Tran Quynh Trang - Doctor of Biochemistry - Laboratory Department - Vinmec Times City International Hospital

Articles source references: Webmd.com, Mayoclinic.org