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Autoimmune Hepatitis

Autoimmune hepatitis occurs when the body's own immune system attacks the liver, causing inflammation or hepatitis. The disorder disproportionately affects women, with roughly 70 percent of cases occurring in females. Like other autoimmune disorders, this form of hepatitis may be triggered by a bacterial or viral infection, environmental factors or medications in genetically susceptible individuals. Untreated, autoimmune hepatitis can lead to cirrhosis (scarring) and liver failure. Virginia Mason hepatologists specialize in treating patients with autoimmune hepatitis. To schedule an appointment with Virginia Mason's Liver Center specialists, call (206) 223-2319.

Symptoms of Autoimmune Hepatitis

There are two forms of autoimmune hepatitis: type 1 and type 2. The majority of patients have type 1, which typically begins in adolescence or young adulthood. Almost half of individuals with type 1 disease also have other autoimmune disorders, including:

  • Type 1 diabetes
  • Graves' disease
  • Sjögren's syndrome
  • Ulcerative colitis
  • Thyroiditis (inflammation of the thyroid gland)

Autoimmune hepatitis is a chronic disorder with symptoms that can worsen over time if not treated. Symptoms include:

  • Fatigue
  • Weakness
  • Itching
  • Nausea
  • Vomiting
  • Fever
  • Diarrhea
  • Abdominal pain on the right side of the body where the liver is located
  • Jaundice (yellow skin and eyes)
  • Dark urine

Diagnosing Autoimmune Hepatitis

Your hepatologist will first perform a medical history and a physical exam, and will listen to a description of your symptoms. He or she may suspect autoimmune hepatitis based on your signs and symptoms, and whether you have been diagnosed previously with an autoimmune disorder. You may have several tests and procedures to confirm the diagnosis and determine the extent of liver damage, including:

    A blood test can confirm a diagnosis of hepatitis. If your hepatologist suspects autoimmune hepatitis based on your medical history, he or she will also order blood tests that can confirm the presence of autoantibodies, which are natural proteins released in the bloodstream to help fight infection.
    A liver biopsy is performed by injecting a thin needle through your abdominal skin (percutaneously) and into the liver to remove a small sample of liver tissue. The area of the puncture is numbed first with a local anesthetic.

Treating Autoimmune Hepatitis

Autoimmune hepatitis is a chronic disorder requiring lifelong treatment. Depending on the severity of symptoms, your hepatologist may prescribe a corticosteroid medication called prednisone that slows the body's immune system. Because prednisone has side affects, your hepatologist may prescribe another medication to be taken with it called azathioprine (Imuran). With azathioprine, you can take lesser doses of prednisone, which lessens its side effects.

Most patients with autoimmune hepatitis will need to take medication to suppress the immune system throughout their lives, which helps control the disease and avoid further damage to the liver.