Autoimmune hepatitis
Lupoid hepatitis; Chronic active hepatitisAutoimmune hepatitis causes inflammation of the liver. It occurs when immune cells mistake the liver's normal cells for harmful invaders and attack them.
Causes
This form of hepatitis is an autoimmune disease. The body's immune system cannot tell the difference between healthy body tissue and harmful, outside substances. The result is an immune response that destroys normal body tissues.
Autoimmune disease
An autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 autoimmune d...
Liver inflammation, or hepatitis, may occur along with other autoimmune diseases. These include:
-
Graves disease
Graves disease
Graves disease is an autoimmune disorder that leads to an overactive thyroid gland (hyperthyroidism). An autoimmune disorder is a condition that occ...
Read Article Now Book Mark Article -
Inflammatory bowel disease
Inflammatory bowel disease
Ulcerative colitis is a condition in which the lining of the large intestine (colon) and rectum become inflamed. It is a form of inflammatory bowel ...
Read Article Now Book Mark Article -
Rheumatoid arthritis
Rheumatoid arthritis
Rheumatoid arthritis (RA) is a disease that leads to inflammation of the joints and surrounding tissues. It is a long-term disease. It can also aff...
Read Article Now Book Mark Article -
Scleroderma
Scleroderma
Scleroderma is a disease that involves the buildup of fibrous tissue in the skin and elsewhere in the body. It also damages the cells that line the ...
Read Article Now Book Mark Article -
Sjögren syndrome
Sjögren syndrome
Sjögren syndrome is an autoimmune disorder in which the glands that produce tears and saliva are destroyed. This causes dry mouth and dry eyes. The...
Read Article Now Book Mark Article -
Systemic lupus erythematosus
Systemic lupus erythematosus
Systemic lupus erythematosus (SLE) is an autoimmune disease. In this disease, the immune system of the body mistakenly attacks healthy tissue. It c...
Read Article Now Book Mark Article -
Thyroiditis
Thyroiditis
Chronic thyroiditis is caused by a reaction of the immune system against the thyroid gland. It often results in reduced thyroid function (hypothyroi...
Read Article Now Book Mark Article -
Type 1 diabetes
Type 1 diabetes
Type 1 diabetes is a lifelong (chronic) disease in which there is a high level of sugar (glucose) in the blood.
Read Article Now Book Mark Article -
Ulcerative colitis
Ulcerative colitis
Ulcerative colitis is a condition in which the lining of the large intestine (colon) and rectum become inflamed. It is a form of inflammatory bowel ...
Autoimmune hepatitis may occur in family members of people with autoimmune diseases. There may be a genetic cause.
This disease is most common in young girls and women.
Symptoms
Symptoms may include:
-
Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
Read Article Now Book Mark Article - General discomfort, uneasiness, or ill feeling (malaise)
Malaise
Malaise is a general feeling of discomfort, illness, or lack of well-being.
Read Article Now Book Mark Article -
Itching
Itching
Itching is a tingling or irritation of the skin that makes you want to scratch the area. Itching may occur all over the body or only in one location...
Read Article Now Book Mark Article -
Loss of appetite
Loss of appetite
A decreased appetite is when your desire to eat is reduced. The medical term for a loss of appetite is anorexia.
Read Article Now Book Mark Article - Nausea or vomiting
- Joint pain
-
Pale or clay-colored stools
Pale or clay-colored stools
Stools that are pale, clay, or putty-colored may be due to problems in the biliary system. The biliary system is the drainage system of the gallblad...
Read Article Now Book Mark Article -
Dark urine
Dark urine
Blood in your urine is called hematuria. The amount may be very small and only detected with urine tests or under a microscope. In other cases, the...
Read Article Now Book Mark Article -
Abdominal distention
Abdominal distention
A swollen abdomen is when your belly area is bigger than usual.
Absence of menstruation (amenorrhea) may also be a symptom.
Exams and Tests
Tests for autoimmune hepatitis include the following blood tests:
- Liver function tests
- Anti-liver kidney microsome type 1 antibody (anti LKM-1)
Microsome type 1 antibody
Thyroid peroxidase is a type of protein (called an enzyme) that cells in the thyroid gland use to make thyroid hormone. If these enzymes leak out in...
Read Article Now Book Mark Article - Anti-nuclear antibody (ANA)
ANA
The antinuclear antibody panel is a blood test that looks at antinuclear antibodies (ANA). ANA are antibodies produced by the immune system that bind...
Read Article Now Book Mark Article - Anti-smooth muscle antibody (SMA)
- Serum IgG
- Liver biopsy to look for long-term hepatitis
Treatment
You may need prednisone or other corticosteroid medicines to help reduce the inflammation. Azathioprine and 6-mercaptopurine are drugs used to treat other autoimmune disorders. They have also been shown to help people with autoimmune hepatitis.
Some people may need a liver transplant.
Outlook (Prognosis)
The outcome varies. Corticosteroid medicines may slow the progress of the disease. However, autoimmune hepatitis may advance to cirrhosis. This could require a liver transplant.
Possible Complications
Complications may include:
-
Cirrhosis
Cirrhosis
Cirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease.
Read Article Now Book Mark Article - Side effects from steroids and other medicines
-
Hepatocellular carcinoma
Hepatocellular carcinoma
Hepatocellular carcinoma is cancer that starts in the liver.
Read Article Now Book Mark Article - Liver failure
-
Bleeding from varices
Bleeding from varices
The esophagus (food pipe) is the tube that connects your throat to your stomach. Varices are enlarged veins that may be found in the esophagus in pe...
Read Article Now Book Mark Article -
Ascites
Ascites
Ascites is the build-up of fluid in the space between the lining of the abdomen and abdominal organs.
Read Article Now Book Mark Article -
Hepatic encephalopathy
Hepatic encephalopathy
Loss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy (HE). This problem ma...
When to Contact a Medical Professional
Contact your health care provider if you notice symptoms of autoimmune hepatitis.
Prevention
In most cases, autoimmune hepatitis cannot be prevented. Knowing the risk factors may help you detect and treat the disease early.
References
Czaja AJ. Autoimmune hepatitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 90.
Pawlotsky J-M. Chronic viral and autoimmune hepatitis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 140.
-
Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
illustration
-
Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
-
Digestive system - illustration
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
illustration
-
Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
Review Date: 11/2/2022
Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.