Autoimmune Hepatitis Causes Cirrhosis of the Liver

Cirrhosis of the Liver

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Autoimmune Hepatitis

Autoimmune hepatitis is a disease that can be mild or very serious as it causes inflammation of the liver. Sometimes autoimmune hepatitis is caused by a particular medication, and other times it is simply an autoimmune disease without a definitive cause. Some physicians think there is a genetic component for some patients. It is a type of chronic hepatitis that leads to progressive liver damage, and in 10–20 percent of the cases it acts like acute hepatitis.

What is an Autoimmune Disorder?

No one knows why the liver is targeted by the immune system, which is similar to the many autoimmune disorders I wrote about in 80 Types of Autoimmune Diseases. Somehow the body no long recognizes the differences between invading bacteria and viruses and healthy tissues.

Type 1 autoimmune hepatitis is the most common type found in North America, affecting approximately one in every 235,294 people, and it is more common in women. Quite often it occurs in adolescence or your adulthood, but may occur at any age. Approximately one half of the people that have this disease also have another autoimmune disease. Type II is rare and affects females between two and 14.

Risk and Symptoms of Hepatitis

Textbook
Textbook

Ascitis - Fluid in Abdomin with Liver Failure

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Liver Disease Symptoms

There are several typical symptoms that are common with this disease. These symptoms include:

  • Fatigue – most common complaint
  • Skin rashes
  • Joint pain
  • Abdominal discomfort
  • Spider angiomas and other blood vessel abnormalities on the skin
  • Enlarged liver
  • Jaundice
  • Pale or gray-colored stools
  • Nausea
  • Vomiting
  • Appetite loss
  • Dark urine
  • Itching
  • Ascites – fluid collected in the abdomen

In advanced liver disease, ascites it also common, which is fluid that collects in the abdomen, and this may cause mental confusion as well. Menstrual symptoms stop for women also.

Diagnosis of this Liver Disease

Diagnosis for hepatic disease includes a number of blood tests, and other types of tests depending on the degree of illness. The primary blood test is the Anti-Smooth Muscle Antibody (ASMA), which is a specific test for autoimmune hepatitis as it detects antibodies that attack smooth muscles. Muscles are made up of myosin II, which are heavy chains of long fibers, and actin, which are thinner filaments, important for contractile movement. The actin is the fiber being attacked in this autoimmune disorder.

Striated muscles are found in the long muscle of the arms and legs. Smooth muscles are found in the organs of the body, such as in the gastrointestinal tract, blood vessel walls and many other places. When the antibodies that attack smooth muscles are present, they cause inflammation, which is destructive.

There are other blood tests that will be evaluated, such as liver enzyme tests, the AMA test which looks a smooth body antibodies, an ANA, ALT and SMA to look at inflammation and liver function. Liver biopsies are done for the more severe cases.

Medication Treatments

If antibodies attack the liver and the patient does not receive any medical treatment, they will get cirrhosis of the liver, and eventually have complete liver failure. No medications are available as a cure, but treatment is focused on slowing the disease progress. With treatment approximately seven out of 10 people will go into a remission within two years of beginning treatment. It is quite common for patients to need treatment off and on through the years once they receive this diagnosis.

  • Corticosteroid medication in the form of prednisone is a common treatment, and it starts at a high dosage initially. Then, it is reduced to the lowest dosage that will still treat the disease. The average patient will require 18 to 24 months of this treatment.
  • Azathioprine (Azusa, Imuran) is also an immunosuppressant medication that is sometimes given in conjunction with prednisone. Taking this medication suppresses the immune system, so infections can become a problem.
  • Other immunosuppressants may be used if the others listed above are ineffective. They include CellCept, cyclosporines or Prograf.

If these medications do not work, the patient will need a liver transplant.

Summary

Symptoms of this disease will often lessen over the years with medical treatment as seven out of 10 people go into remission; however, the disease usually reoccurs throughout their lifetime, and treatment will begin again. The prognosis for individuals is not easy as all people do not respond in the same way to the same treatments. Remember that prognosis is only a medical opinion, not a fact.

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Comments 24 comments

Wayne Brown profile image

Wayne Brown 3 years ago from Texas

Interesting...I knew of two types of Hepatitis but did not know that it could develop as a result of the body just turning on itself. It has many characteristics of Type I Diabetes in that the immune system basically destroys the pancreas' ability to produce ilet cells to balance blood glucose in the body...we don't know what causes that either. As smart as we are...we have a long way to go to understand all the pathways in the human body. Good reading, Pam...thanks for sharing it. ~WB


Pamela99 profile image

Pamela99 3 years ago from United States Author

Wayne, That is so true. Autoimmune diseases seem to be one of the hardest types of disease to cure and they only treat symptoms in most cases. That means so cure. I wish you good health in the future. I have great hope for stem cell cures, but that takes time. Thanks so much for your comments.


billybuc profile image

billybuc 3 years ago from Olympia, WA

I've had a few friends in AA die of cirrhosis of the liver....not a pretty sight to see. Thank you for this valuable and important information.


rebeccamealey profile image

rebeccamealey 3 years ago from Northeastern Georgia, USA

Scary stuff. Thanks for keeping us in the loop on this disease. Even though there is no cure, I am glad that it can be held at bay.


mollymeadows profile image

mollymeadows 3 years ago from The Shire

I knew about many autoimmune diseases, but not that the liver could be affected. Thanks for the heads up!


bassia 3 years ago

thank you for the information .I really appreciate it.


Pamela99 profile image

Pamela99 3 years ago from United States Author

Molly, It is always good to be informed and with the vareity of autoimmune diseases out there, most any organ can be affected. It would be nice if scientist would come up with some cures. I appreciate your comments.


Pamela99 profile image

Pamela99 3 years ago from United States Author

bassia, I appreciate your comments.


Faith Reaper profile image

Faith Reaper 3 years ago from southern USA

Hi Pamela,

Very interesting article. I was not aware that the liver could be affected by autoimmune diseases.

Thanks so much for this insightful piece here.

Voted up ++ and sharing

God bless, Faith Reaper


Sue Bailey profile image

Sue Bailey 3 years ago from South Yorkshire, UK

I am going to show this to a friend. Her symptoms sound pretty much like these.


always exploring profile image

always exploring 3 years ago from Southern Illinois

Interesting and useful info. Pam. Thank you for all of your informative hubs on diseases and treatments..


Nell Rose profile image

Nell Rose 3 years ago from England

Hi Pamela, I remember a friend having Hepatitis, she never went into detail so I am not sure how she got it, but this goes a long way to explaining it properly for me so thank you, fascinating hub, and voted up and shared! nell


Pamela99 profile image

Pamela99 3 years ago from United States Author

Faith, I am glad you found the hub insightyful. I appreciate your comments and the share.


Pamela99 profile image

Pamela99 3 years ago from United States Author

Sue, I hope she doesn't have this disease, but I am glad you have this information. Thanks for your comment.


Pamela99 profile image

Pamela99 3 years ago from United States Author

Ruby, It is always interesting to write the medical hubs as invariably someone will have the disease or know someone with the symtptoms. Thanks so much for your comments.


Pamela99 profile image

Pamela99 3 years ago from United States Author

Nell Rose, There are about four types of hepatitis, but the symptoms are the same. I am glad you enjoyed the hub and appreciate your comments.


dilipchandra12 profile image

dilipchandra12 3 years ago from India

Very well written hub, it is informative.


Pamela99 profile image

Pamela99 3 years ago from United States Author

dilpchandra, I am glad you found the hub interesting and your comments are appreciated.


starbright profile image

starbright 3 years ago from Scandinavia

Very interesting and informative hub - bit scary though. Thanks for sharing your invaluable insight. Voted up.


Pamela99 profile image

Pamela99 3 years ago from United States Author

starbright, It is a bit scary, but being informed I think is good. That way if you or a loved one gets some strange symptoms you will know that you need medical treatment.. Thanks for your comments.


drbj profile image

drbj 3 years ago from south Florida

Very thorough and informative, Pam. Now I don't have to rely only on my Merck's Manual any more. ;)


Pamela99 profile image

Pamela99 3 years ago from United States Author

drbj, My Merck Manual is collecting dust. :) I'm sure your are quite well informed. Thanks for your comments.


pstraubie48 profile image

pstraubie48 3 years ago from sunny Florida

I know a little about this condition as I had an Uncle who suffered from it. But I was a week bit of a girl and really did not know the full story. Your detailed explanation has now cleared up some of the questions I had.

Angels are winging their way to you this morning, Pamela. ps


Pamela99 profile image

Pamela99 3 years ago from United States Author

Patircia, It is certainly not a good disease to have and I am sorry to hear your uncle suffered with it. Thanks for the comments ane I love the angels. More are sent back to you also! Have a wonderful day.

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