Autoimmune hepatitis

What is autoimmune hepatitis?

Autoimmune hepatitis (AIH) refers to a chronic inflammatory disease of the liver which is rare but can lead to cirrhosis or liver failure if left untreated. The characteristic feature of this disease is hepatitis (inflammation of the liver) which is brought on by a dysregulated immune system which attacks your own liver cells by mistake.

The majority of AIH patients are female and it can manifest at any age. However, especially middle-aged adults to elderly patients (between 40 and 70 years) are affected.

Causes and symptoms

The precise cause of why the immune system fails to tolerate the liver is still unclear. There are suspected genetic factors that favor the emergence of AIH, as well as certain environmental influences, including exposure to toxins or bacterial and viral infections.

AIH can range from an asymptomatic presentation to an acute symptomatic state. which include general malaise, fatigue, pain in the upper right abdomen, nausea, itching or joint pain. Later on, this disease may often progress to liver cirrhosis, resulting in jaundice or ascites.

How is autoimmune hepatitis diagnosed?

Diagnosing AIH is a complex process based on three criteria. Firstly, laboratory chemistry is performed on the patient's blood, investigating the presence of certain markers that are suggestive of AIH. Secondly, a histological analysis of the liver is done, meaning that a tiny bit of liver tissue is extracted during a liver biopsy and examined under the microscope. Moreover, patient's clinical symptoms are also included in the diagnosis.

It is also important to exclude any other causes of hepatitis, for instance viral hepatitis B.

Therapy: What medications can be used for autoimmune hepatitis?

The primary therapy for AIH involves a combination of glucocorticoids ("cortisone preparations") and azathioprine. Corticosteroids will suppress the immune system and thereby protect the liver from additional damage, however, these medications have side effects in long-term regimens. Among them are a puffy face, osteoporosis, the development of diabetes and glaucoma. In order to keep the corticosteroid dosage as low as possible, azathioprine is added to the regimen. This will also lower the side effects.

Chances of cure and prognosis

There is no cure for AIH, but a well-controlled therapeutic regimen can result in complete halt of the disease (this is called remission), allowing patients to be free of symptoms and prevent further progression of AIH to the stage where liver transplantation may be necessary.

An early diagnosis and initiation of immunosuppressive treatment are crucial for a favorable prognosis. Hence, most patients affected by AIH will have a good prognosis. It is only in patients who fail to respond adequately to therapy that the risk of developing liver cirrhosis with possible liver failure is increased.

Which doctors and clinics are specialized in the diagnosis and treatment in lung operations?

Gastroenterology is the medical specialty concerned with diagnosis and therapy of liver disorders, among others.

If you're in need of a doctor, you expect the best medical care possible. So of course patients are curious to find out what clinic to go to. As there is no objective way to answer this question and a legitimate doctor would never claim to be the best, patients must rely on a doctor's experience.

Let us help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in the field of autoimmune hepatitis and are looking forward to your inquiry or wish for treatment.

Sources: 

• „Autoimmunhepatitis- Klinik, Diagnostik, Therapie“ im „Journal für Gastroenterologische und Hepatologische Erkrankungen“, 2018, Albert Friedrich Stättermayer & Emina Halilbasic 
• Leitlinie Autoimmune Lebererkrankungen à www.awmf.org/uploads/tx_szleitlinien/021-027l_S2k_Autoimmune_Lebererkrankungen_2017-11.pdf