Autoimmune Hepatitis

Autoimmune hepatitis is a disease of the liver that occurs when a person’s immune system attacks its own liver cells. The immune response causes inflammation of the liver and the disease can lead to other symptoms, including cirrhosis—scarring and hardening—of the liver.

Autoimmune hepatitis has an incidence of 1-2 per 100,000 per year. It affects women 70% more often than men. It can occur at any age but most often starts in adolescence or young adulthood.

The disease is usually quite serious and, if not treated, gets worse over time. Autoimmune hepatitis is typically chronic, meaning it can last for years. Eventually, liver failure can result.

Symptoms of autoimmune hepatitis vary, depending on the severity. However, some of the more common include:

  • Fatigue
  • Enlarged liver
  • Jaundice, a condition that causes a yellowing tint of the skin and eyes
  • Joint pain
  • Abdominal discomfort
  • Blood vessels that appear as “spiders” on the surface of the skin
  • Nausea
  • Vomiting
  • Loss of appetite
  • Dark urine
  • Mental confusion, which may occur in advanced stages

People in advanced stages of the disease are more likely to have symptoms related to chronic liver disease, such as fluid in the abdomen (ascites) and mental confusion. Women may stop having menstrual periods.

Treatment is with glucocorticoids with or without azathioprine. Patients who do not respond to glucocorticoids and azathioprine may be given other immunosuppressives. Treatment with medication causes remission in up to 60–80% of cases, although many will eventually experience a relapse.

Liver transplantation may be required if patients do not respond to drug therapy or when patients present with sudden and intense liver failure.