What is it about ?
Hepatitis is inflammation of the liver. The adjective “autoimmune” means that the cause is an immune system reaction against liver cells. It is still unclear why the body reacts like this.
In whom and how often does it occur?
About 17 in 100,000 people have autoimmune hepatitis. In 70 to 80% of cases, it is women, and, 1 time out of 2, it is less than 30 years old.
How to recognize it?
In the light form, the affection can evolve without the slightest complaint. The first symptoms are usually vague, like a tired, loss of appetite (with distaste for fatty food and alcohol), weightloss, …
In 30 to 40% of people affected, the condition begins very suddenly, with a jaundice – that is, yellowing of the skin and whites of the eyes. Small red branched dots may appear on the skin due to the dilation of the blood vessels. They disappear when you apply pressure with your finger.
Stomach aches and joint pain can also occur.
Since the liver is also involved in making hormones, women can no longer have rules and men can develop a gynecomastia (appearance of breasts).
At an advanced stage, a liver cirrhosis. The liver is no longer functioning properly, and scarring in the liver blocks blood flow. A red coloration of the palms of the hands is a characteristic symptom. The belly can also swell due to the accumulation of fluid (ascites).
Out of 10 people with autoimmune hepatitis, 4 simultaneously suffer from other autoimmune diseases.
How is the diagnosis made?
In the absence of symptoms, the diagnosis is often discovered by chance during a blood test: the liver tests are abnormal. Sometimes the doctor can feel an enlarged liver and spleen during a stomach exam.
A definitive diagnosis requires a liver biopsy. The procedure is performed under local anesthesia and involves removing a small piece of tissue from the liver using a needle and then sending it to the lab for analysis. If the disease progresses, the biopsy should be repeated every 2-3 years.
What can you do ?
Avoid alcohol because it is toxic to the liver.
Also, avoid taking medication without your doctor’s or pharmacist’s advice. Indeed, many drugs are broken down by the liver. So limit yourself to medications prescribed by the doctor.
What can your doctor do?
Mild and moderate forms can go away spontaneously, without treatment.
For severe autoimmune hepatitis, treatment consists of drugs that suppress the immune system, such as cortisone and azathioprine. Medication should be continued until a biopsy shows that the disease is no longer active.
If left untreated, autoimmune hepatitis can be life threatening. With treatment, 8-9 in 10 patients are still alive after 10 years.
If the liver is no longer functioning, a transplant may be necessary.
Want to know more?
- Corticosteroids – CBIP – Belgian Center for Pharmacotherapeutic Information
- Azathioprine – CBIP – Belgian Center for Pharmacotherapeutic Information
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