Autoimmune Hepatitis | Digestive Health | Loyola Medicine

Autoimmune Hepatitis

Overview and Facts about Autoimmune Hepatitis

Autoimmune hepatitis is a disease that affects liver structure and function. This disease is particularly characterized by the immune system attacking normally functioning liver cells.  Autoimmune hepatitis is a chronic disease that can become severe over a lifetime and is characterized as type 1 and type 2 hepatitis. Approximately 70% of autoimmune hepatitis cases in North America are type 1 and found in women. Type 2 most often occurs in children rather than adults.

Under normal or healthy conditions, the liver is responsible for detoxifying the body and maintaining digestive health. In autoimmune hepatitis, the immune system mistakes normal liver cells for harmful abnormal cells or substances and attacks the liver. This attack causes liver inflammation and damage, which may lead to liver cirrhosis (scarred liver tissue that blocks normal blood flow to and from the liver), liver cancer, and/or liver failure.

Signs and Symptoms of Autoimmune Hepatitis

Individuals with autoimmune hepatitis may experience little or no symptoms, especially during the early stages of the disease. Signs and symptoms often begin to appear during young adulthood. Once the disease has progressed or become severe, the most common symptoms include:

  • Abdominal pain
  • Amenorrhea (absence of menstrual period) in some women
  • Dark-yellow urine
  • Enlarged liver or spleen
  • Extreme tiredness or fatigue
  • Flu-like symptoms or overall feelings of malaise​
  • Itching
  • Joint pain and/or swelling
  • Light-colored stool
  • Nausea and vomiting
  • Spider veins

Causes and Risk Factors of Autoimmune Hepatitis

Individuals with a family history of autoimmune hepatitis have a higher risk of developing the disease. Females are also more likely to be diagnosed with autoimmune hepatitis than males. High levels of protein antibodies in the blood increases the risk of autoimmune hepatitis as well, as antibodies are responsible for signaling an attack by the immune system. Other forms of autoimmune diseases, which include ulcerative colitis, type 1 diabetes, and Graves' disease, are also linked to, or increase the likelihood of developing, autoimmune hepatitis.

Tests and Diagnosis for Autoimmune Hepatitis

There are many ways to diagnose autoimmune hepatitis. Blood tests or liver function tests for antibodies that are specific to autoimmune hepatitis and other liver diseases are often performed. These blood tests look for antibodies that include serum IgG, anti-nuclear antibody, and anti-smooth muscle antibody. A small amount of liver tissue may be removed with a needle and examined under a microscope to look for signs of autoimmune hepatitis. Ultrasounds, CT scans, and MRI are imaging techniques that can also be used to look for signs of autoimmune hepatitis.

Treatment and Care for Autoimmune Hepatitis

In some cases, autoimmune hepatitis may improve without medical treatment and by making lifestyle modifications that reduce the chances of immune system attack on the liver. For those who require treatment, corticosteroids such as prednisone are often administered to help reduce inflammation in the body. In severe cases of liver failure, a liver transplant may be necessary.