Synopsis: The overall outlook for persons with autoimmune hepatitis is generally very favorable.
The human body has a number of organs, and the liver is one of the largest. The liver is located in the upper-right portion of a person's abdomen behind their ribs and is a highly complex organ with various functions. The liver stores many different things, including iron, minerals, vitamins, and energy in the form of sugar. The liver processes red blood cells that have been worn out, and metabolizes things such as medications. It produces proteins, to include blood clotting factors, which keep the person's body healthy while assisting it to grow. The liver destroys germs that may enter the person's body through their intestine. The also produces bile, something that is needed for food digestion.
The liver does many jobs, possessing the ability to regenerate itself to some degree; an ability that should not be taken for granted. A person's liver is subject to a variety of different illnesses that may lead to permanent damage. One example of such an illness is Autoimmune Hepatitis, which is a condition where the person's body actually fights against it's own liver.
When cells in a person's body sustain injury through exposure to things such as an infection or chemicals, the area that has been affected becomes inflamed. Hepatitis is inflammation of the liver that then causes damages to liver cells. Hepatitis is most commonly caused by a viral infection, although it may also be caused by specific drugs, alcohol, some diseases, poisons, or chemicals.
Hepatitis may be described as either, 'chronic,' or, 'acute;' the inflammation quickly develops, lasting for short periods of time. Persons with hepatitis commonly recover completely, yet it may take several months in order to recover completely. On occasion, people fail to recover fully from hepatitis. When this occurs the hepatitis they experience is described as, 'chronic,' and the hepatitis may develop over a period of years without the person experiencing acute hepatitis, or even feeling ill. While a person's liver repairs itself there is the potential for fibrous tissue to develop, such as scar tissue around a cut or other form of injury on the skin that has healed. Scarring of the liver that is advanced is referred to as, 'cirrhosis,' and over a period of time cirrhosis can irreversibly damage a person's liver, ultimately ending in liver failure.
One part of the human immune system is the white blood cells that assist in fighting off infections. Some of these cells produce antibodies that defend the person's body by destroying viruses, bacteria, and additional foreign materials. There are various kinds of antibodies; each of them works against a particular foreign substance. On occasion, a person's immune system recognizes their own organs as something that is foreign, developing antibodies that work against them. The results can be a number of different illnesses; lupus, or rheumatoid arthritis for example. The illnesses that are a result of a person's immune system fighting against a person's own organs are referred to as, 'autoimmune disorders.'
When a person's immune system attacks their liver because it perceives it as something that is foreign, it is referred to as, 'Autoimmune Hepatitis.' Autoimmune Hepatitis is not something that is caused by either a virus or bacteria, and is not contagious. Medical science does not understand exactly what triggers a person's immune system to fight against their liver in this way. The inflammation a person experiences in association with autoimmune hepatitis is chronic; without receiving treatment their symptoms may lead to severe liver injury.
Autoimmune Hepatitis: Symptoms and Diagnosis
Autoimmune hepatitis is something that commonly occurs in adolescent or young adult women; however, there are also documented cases of both older women and men who have developed the disease. The early symptoms of autoimmune hepatitis are the same as they are for the majority of the types of hepatitis; abdominal discomfort, aching joints, and fatigue. Sometimes, these early symptoms may be mistaken for the symptoms of other illnesses; the flu for example. It is always a wise decision to consult a doctor if you are experiencing these symptoms. Autoimmune hepatitis that has progressed to severe cirrhosis can present symptoms in people affected such as jaundice, intestinal bleeding, mental confusion, and a marked swelling in the person's abdomen caused by fluid buildup in their abdomen.
Physicians often suspect autoimmune hepatitis based upon a person's medical history. Persons with additional autoimmune diseases such as ulcerative colitis, diabetes, thyroiditis, Sjogren's syndrome, or vitiligo, are often more likely to experience autoimmune hepatitis as well. A diagnosis of autoimmune hepatitis can be reached through blood testing of the person. There are two antibodies that can develop in the person's blood; Antinuclear Antibody (ANA), and Smooth Muscle Antibody (SMA). There is also a specific type of blood protein known as, 'Gamma Globulin,' which is frequently elevated in persons with autoimmune hepatitis. Physicians always pursue a liver biopsy in order to determine the level of inflammation and scarring the person has developed. The liver biopsy is done under a local anesthesia; a needle is inserted through the person's right-lower chest in order to extract a small piece of liver tissue. Once the tissue has been extracted, it is examined underneath a microscope; the resulting information that is obtained provides the physician with the opportunity to tailor particular treatment to the individual.
Autoimmune Hepatitis: Treatment
Treatment of autoimmune hepatitis is currently aimed at curbing the autoimmune response associated with the disease, with the goal of preventing damage to the person's liver cells. In the majority of cases, initial treatment includes administration of a cortisone medication such as Prednisone. Another medication like Imuran may be used as well. Medication is usually taken on a daily basis, commonly for at least a year. A physician might try to taper off or cease treatment if the person is doing well enough. Should the person experience a relapse, a physician will restart the medication regimen; most likely indefinitely.
Side-effects of Prednisone may include fluid retention, swelling of the person's face, and weight gain. Long-term treatment can cause bone loss, leading to osteoporosis or damage to the person's joints; possibly in their knees or shoulders. A doctor will try to use the lowest possible dose of medication in an attempt to decrease the person's symptoms while improving their liver tests while slowing damage done to their liver.
Some people with autoimmune hepatitis do not respond as well to treatment as others, particularly if the disease is diagnosed late, or if the cirrhosis they experience is advanced. For persons who do not respond to treatment who also have severe liver damage, a liver transplant is something that may be considered. Advances in the surgical techniques involved with liver transplantation, as well as the use of new medications which suppress rejection of transplanted organs, have improved the success rate of liver transplants. The outcome for persons with autoimmune hepatitis in relation to liver transplants is excellent. The survival rates related to autoimmune hepatitis and liver transplants at transplant centers are above ninety-percent, and people who have experienced a liver transplant can expect to have a good quality of life afterward.
The overall outlook for persons with autoimmune hepatitis is generally very favorable. Persons who are diagnosed early and receive medication treatment in order to prevent serious liver damage find that the treatment is effective. For people who do not respond to treatments, liver transplants have become a very viable option, with a high rate of success.