Hepatitis (Autoimmune)

What is it?
The liver is an organ that is housed in the upper right side of your abdomen, mostly behind the ribs. It is about the size of a football, and has many functions. It stores energy and nutrients, makes proteins, breaks down and filters substances, processes old red blood cells, and kills germs that enter the body through the intestines. In this condition, the liver cells are inflamed, because your immune system attacks them. It is unclear why this happens, but may be linked to certain diseases, toxins or drugs. It can happen in children, and adults of all ages. With continued inflammation, the liver can become scarred, eventually leading to cirrhosis and liver failure.

What are the symptoms?
This condition is variable, ranging from no symptoms to liver failure. Symptoms can include:

  • Fatigue
  • Lack of appetite
  • Abdominal pain
  • Itching
  • Joint pain
  • Yellowing of the skin or eyes
  • Dark urine and pale stool
  • Skin rashes
  • Nausea
  • Vomiting

Other autoimmune diseases, may also be present as well, such as; diabetes, thyroid
issues, celiac disease or ulcerative colitis.

How is it diagnosed?
Often, suspicion for this disorder is raised based on your history, and blood work findings. Specific antibodies, (proteins made by your body’s immune system) may be present. Sometimes a liver biopsy is necessary.

How is it treated?
Not everyone with this condition requires treatment. Based on your symptoms, and the severity of the disease, the decision, if treatment is necessary, will be made. Often treatment starts a glucocorticoid such as prednisone. This medicine suppresses the immune system throughout the body and prevents continued attack of the liver. While often effective there are many associated side effects because the drug works widely throughout the body. Sometimes other medicines that impact the immune system will be added such as azathioprine, 6-mercaptopurine, methotrexate or mycophenolate.

Treatment is usually continued until there are no signs of continued inflammation of the liver; (remission) unless, the person develops side effects, or the medication does not seem to be making any impact. People typically will be in remission about a year after treatment is started, 65% are in remission by a year and a half, and 80% by three years of treatment. After treatment is stopped, many people will need to be retreated, because the disease can reactivate, and the liver can be attacked.

If the condition does not respond to treatment, or if the disease is severe, liver transplantation may be an option.

What can I do?
Eat a normal, healthy diet and avoid substances that can damage the liver, this includes alcohol, prescription, and over the counter medicines (especially acetaminophen/Tylenol and nonsteoridal anti-inflammatory drugs), herbs, vitamins and dietary supplements.

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