A bit on AIH

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http://digestive.niddk.nih.gov/ddiseases/pubs/autoimmunehep/index.htm

Members of the group will be able to answer most questions you have (if not

all). Joanne

Autoimmune Hepatitis

On this page:

Autoimmune Disease

Symptoms

Diagnosis

Treatment

Side Effects

Other Treatments

Hope Through Research

Points to Remember

For More Information

Autoimmune hepatitis affects

the liver.

Autoimmune hepatitis is a disease in which the body's immune system attacks

liver cells. This causes the liver to become inflamed (hepatitis). Researchers

think a genetic factor may predispose some people to autoimmune diseases. About

70 percent of those with autoimmune hepatitis are women, most between the ages

of 15 and 40.

The disease is usually quite serious and, if not treated, gets worse over time.

It's usually chronic, meaning it can last for years, and can lead to cirrhosis

(scarring and hardening) of the liver and eventually liver failure.

Autoimmune hepatitis is classified as either type I or II. Type I is the most

common form in North America. It occurs at any age and is more common among

women than men. About half of those with type I have other autoimmune disorders,

such as type 1 diabetes, proliferative glomerulonephritis, thyroiditis, Graves'

disease, Sjögren's syndrome, autoimmune anemia, and ulcerative colitis. Type II

autoimmune hepatitis is less common, typically affecting girls ages 2 to 14,

although adults can have it too.

Autoimmune Disease

One job of the immune system is to protect the body from viruses, bacteria, and

other living organisms. Usually, the immune system does not react against the

body's own cells. However, sometimes it mistakenly attacks the cells it is

supposed to protect. This response is called autoimmunity. Researchers speculate

that certain bacteria, viruses, toxins, and drugs trigger an autoimmune response

in people who are genetically susceptible to developing an autoimmune disorder.

Symptoms

Fatigue is probably the most common symptom of autoimmune hepatitis. Other

symptoms include

enlarged liver

jaundice

itching

skin rashes

joint pain

abdominal discomfort

fatigue

spider angiomas (abnormal blood vessels) on the skin

nausea

vomiting

loss of appetite

dark urine

pale or gray colored stools

People in advanced stages of the disease are more likely to have symptoms such

as fluid in the abdomen (ascites) or mental confusion. Women may stop having

menstrual periods.

Symptoms of autoimmune hepatitis range from mild to severe. Because severe viral

hepatitis or hepatitis caused by a drug—for example, certain antibiotics—has the

same symptoms, tests may be needed for an exact diagnosis. Your doctor should

also review and rule out all your medicines before diagnosing autoimmune

hepatitis.

Diagnosis

Your doctor will make a diagnosis based on your symptoms, blood tests, and liver

biopsy.

Blood tests. A routine blood test for liver enzymes can help reveal a pattern

typical of hepatitis, but further tests, especially for autoantibodies, are

needed to diagnose autoimmune hepatitis. Antibodies are proteins made by the

immune system to fight off bacteria and viruses. In autoimmune hepatitis, the

immune system makes antinuclear antibodies (ANA), antibodies against smooth

muscle cells (SMA), or liver and kidney microsomes (anti-LKM). The pattern and

level of these antibodies help define the type of autoimmune hepatitis (type I

or type II).

Blood tests also help distinguish autoimmune hepatitis from viral hepatitis

(such as hepatitis B or C) or a metabolic disease (such as 's disease).

Liver biopsy. A tiny sample of your liver tissue, examined under a microscope,

can help your doctor accurately diagnose autoimmune hepatitis and tell how

serious it is. You will go to a hospital or outpatient surgical facility for

this procedure.

Treatment

Treatment works best when autoimmune hepatitis is diagnosed early. With proper

treatment, autoimmune hepatitis can usually be controlled. In fact, recent

studies show that sustained response to treatment not only stops the disease

from getting worse, but also may actually reverse some of the damage.

The primary treatment is medicine to suppress (slow down) an overactive immune

system.

Both types of autoimmune hepatitis are treated with daily doses of a

corticosteroid called prednisone. Your doctor may start you on a high dose (20

to 60 mg per day) and lower the dose to 5 to 15 mg/day as the disease is

controlled. The goal is to find the lowest possible dose that will control your

disease. Etc.............

Jj Cathcart

jjcathcart@...