Re: Auto Immune MAYO CLINIC BIOPSY REQ

[Guest guest]

I could go on and on..... but this is no laughing matter and a much more

dangerous type of hep than hepc.... the amount of damage is absolutely

necessary and disease must be treated....... please please please listen

Anette..... love you dearly, sally

--- nmilover <nmilover@...> wrote:

> Original

> Article:http://www.mayoclinic.com/health/autoimmune-hepatitis/DS00676

> Autoimmune hepatitis

>

> Introduction

>

> A number of factors can cause the serious liver disease hepatitis,

> including viral infections, alcohol and certain drugs. But in autoimmune

> hepatitis, the problem is different: Your body's own immune system

> attacks

> your liver. Although the reason for this isn't entirely clear, some

> diseases, toxins and drugs may trigger autoimmune hepatitis in

> susceptible

> people, especially women.

>

> Untreated autoimmune hepatitis can lead to scarring of the liver

> (cirrhosis) and eventually to liver failure. When diagnosed and treated

> early, however, autoimmune hepatitis often can be controlled with drugs

> that suppress the immune system. Yet these medications, which often must

> be taken long term, carry a number of risks and aren't always effective.

> A

> liver transplant may be an option when autoimmune hepatitis doesn't

> respond to drug treatments or in cases of advanced liver disease.

>

> Signs and symptoms

>

> Signs and symptoms of autoimmune hepatitis can range from minor to

> severe

> and may come on suddenly or develop over time. Some people have few, if

> any, problems in the early stages of the disease, whereas others

> experience signs and symptoms that may include:

>

> Anemia

> Fatigue

> Abdominal discomfort

> Joint aches (arthralgias)

> Itching (pruritus)

> Yellowing of the skin and whites of the eyes (jaundice)

> An enlarged liver

> Abnormal blood vessels on the skin (spider angiomas)

> Nausea and vomiting

> Liver scarring (cirrhosis)

> Fluid in the abdomen (ascites) or mental confusion, in advanced cases

> It's common for people with autoimmune hepatitis to have other

> autoimmune

> disorders, such as:

>

> Hemolytic anemia, a type of anemia that occurs when red blood cells are

> destroyed faster than the bone marrow can replace them

> Chronic inflammation of the thyroid gland (thyroiditis)

> Inflammation of the colon (ulcerative colitis)

> Diabetes

> Dry eyes and mouth (Sjogren's syndrome)

> Causes

>

>

> CLICK TO ENLARGE

>

> The liver

>

> The liver is not only the largest internal organ in your body, it's also

> one of the hardest working and most complex. It performs hundreds of

> vital

> functions, including processing most nutrients, producing bile and

> blood-clotting factors, and removing drugs, alcohol and other harmful

> substances from your bloodstream. Because the constant exposure to a

> multitude of toxins can damage the liver and lead to hepatitis, many

> cases

> of hepatitis are alcohol or drug related.

>

> But in autoimmune hepatitis, the threat is much closer to home. The

> body's

> immune system, which ordinarily attacks viruses, bacteria and other

> pathogens, instead targets the liver, leading to chronic inflammation

> and

> increasingly serious damage to liver cells. Just why the body turns

> against itself is unclear, but autoimmune hepatitis appears to be

> triggered by:

>

> Infections. Autoimmune hepatitis can develop after a viral infection

> such

> as acute hepatitis A, hepatitis B, measles or Epstein-Barr virus

> infection. Epstein-Barr is one of the most common human viruses and

> linked

> to a number of disorders, including mononucleosis.

> Certain drugs. Some medications injure the liver directly — overdoses of

> the common pain reliever acetaminophen (Tylenol, others), for example,

> can

> cause liver failure. Other drugs harm the liver indirectly by

> stimulating

> an abnormal immune response that then harms liver cells. These drugs

> include interferon, which is commonly used to treat cancer, the high

> blood

> pressure medication methyldopa/hydrochlorothiazide (Aldoril),

> antibiotics

> such as minocycline — often used to treat adolescent acne — and

> nitrofurantoin, the anti-inflammatory diclofenac, and possibly the

> cholesterol drug atorvastatin (Lipitor).

> Genetic abnormalities. Some people seem genetically predisposed to

> develop

> autoimmune hepatitis. Researchers have identified certain gene deletions

> that increase the likelihood the disease will develop at a young age.

> Other genetic abnormalities may make autoimmune hepatitis more

> aggressive

> and harder to treat.

> Types of autoimmune hepatitis

> Doctors have identified two main forms of autoimmune hepatitis:

>

> Type 1 (classic) autoimmune hepatitis. Often developing suddenly, this

> is

> the most common type of the disease. Although it can occur in anyone at

> any age, most of those affected are young women. About half the people

> with type 1 autoimmune hepatitis have other autoimmune disorders such as

> thyroiditis, rheumatoid arthritis or ulcerative colitis. Their blood is

> also likely to contain antibodies against organ tissue.

> Type 2 autoimmune hepatitis. Although adults can develop type 2

> autoimmune

> hepatitis, it's most common in young girls and often occurs with other

> autoimmune problems. Researchers once thought that type 2 autoimmune

> hepatitis was more difficult to treat than type 1 is, but it now appears

> that both respond equally well to steroid therapy.

> Risk factors

>

> Autoimmune hepatitis is uncommon. Having one or more risk factors for

> the

> disease doesn't mean that you'll develop it — only that you may be more

> susceptible than someone without these risk factors:

>

> Your sex. Although both men and women can develop autoimmune hepatitis,

> the disease is far more common in women than it is in men.

> Age. Type 1 autoimmune hepatitis can occur in older adults, but it's

> most

> common in women between the ages of 15 and 40. Type 2 primarily affects

> young girls.

> A history of certain viral infections. Autoimmune hepatitis may develop

> after a viral infection, especially hepatitis A or B, measles, or

> infection with the Epstein-Barr virus.

> Use of certain medications. The high blood pressure drug

> methyldopa/hydrochlorothiazide (Aldoril), the anti-inflammatory

> diclofenac, the antibiotics minocycline and nitrofurantoin, and perhaps

> atorvastatin (Lipitor) may trigger autoimmune hepatitis in some people.

> Heredity. Certain genetic defects increase the risk of autoimmune

> hepatitis.

> When to seek medical advice

>

> Early signs and symptoms of autoimmune hepatitis can be mild and may

> resemble those of the flu. See your doctor if you have persistent

> fatigue,

> abdominal discomfort or joint aches unrelated to exercise. More serious

> symptoms, such as yellowing of your skin and the whites of your eyes or

> abdominal swelling, require immediate care, especially if you have risk

> factors for autoimmune hepatitis.

>

> Screening and diagnosis

>

> Although your symptoms can alert your doctor to the possibility of liver

> disease, you'll need certain tests to diagnose autoimmune hepatitis.

> These

> include:

>

> Blood tests. Antibody tests can distinguish autoimmune hepatitis from

> viral hepatitis and other disorders with similar symptoms. They also

> help

> pinpoint the type of autoimmune hepatitis you have. Antibodies are

> immune

> system proteins that normally attack harmful viruses and bacteria. But

> in

> autoimmune hepatitis, the antibodies attack the liver.

> Liver biopsy. Doctors perform this test to confirm the diagnosis and to

> determine the degree and type of liver damage. During the procedure, a

> small amount of liver tissue is removed, using a thin needle that's

> passed

> into your liver through a small incision in your skin. The sample is

> then

> sent to a laboratory for analysis.

> Imaging tests. An abdominal ultrasound or abdominal computerized

> tomography (CT) scan can't diagnose autoimmune hepatitis, but doctors

> sometimes use imaging tests to rule out liver cancer, a complication of

> cirrhosis.

> Complications

>

> Autoimmune hepatitis can cause a variety of complications, including:

>

> Pernicious anemia. Associated with a number of autoimmune disorders,

> pernicious anemia occurs when a lack of vitamin B12 interferes with your

> body's ability to form red blood cells. Signs and symptoms of pernicious

> anemia can range from shortness of breath and a rapid heart rate to

> diarrhea, numbness or tingling in your hands and feet, and personality

> changes.

> Hemolytic anemia. In this type of anemia, your immune system attacks and

> breaks down red blood cells faster than your bone marrow can replace

> them.

> Thrombocytopenic purpura. Platelets are blood cells that play a crucial

> role in blood clotting. In thrombocytopenic purpura, your immune system

> attacks and destroys these cells, leading to easy bruising and bleeding.

> Ulcerative colitis. This inflammatory bowel disease can cause severe

> bouts

> of watery or bloody diarrhea and abdominal pain. It occurs in as many as

> three in 10 people with type 1 autoimmune hepatitis.

> Celiac disease. This disease causes an abnormal reaction to gluten, a

> protein found in most grains. Eating gluten sets off an immune response

> that damages the surface of the small intestine, affecting the

> intestine's

> ability to absorb nutrients from food.

> Autoimmune thyroiditis (Hashimoto's thyroiditis). In this condition, the

> immune system attacks the thyroid gland. In some people this causes the

> gland to secrete too little thyroid hormone (hypothyroidism); in others,

> the gland produces too much hormone (hyperthyroidism) and then produces

> too little.

> Type 1 diabetes. In type 1 diabetes, the immune system targets and

> destroys the insulin-producing cells in the pancreas. Insulin plays a

> vital role in making glucose — the body's fuel — available to cells.

> Without insulin, cells starve, and glucose builds up in the bloodstream.

> Diabetes is a serious illness that can damage organs throughout the

> body.

> Rheumatoid arthritis. Another autoimmune disease, rheumatoid arthritis

> occurs when the immune system attacks the lining of your joints, leading

> to stiffness, pain, swelling, and sometimes to deformity and disability.

> Because symptoms don't always appear in the early stages of the disease,

> some people with autoimmune hepatitis develop irreversible scarring of

> liver tissue (cirrhosis) before they're ever diagnosed. Complications of

> cirrhosis include:

>

> Increased blood pressure in the vein from the liver. Blood from your

> intestine, spleen and pancreas enters your liver through a large blood

> vessel called the portal vein. If scar tissue blocks normal circulation

> through your liver, this blood backs up, leading to increased pressure

> within the portal vein (portal hypertension).

> Enlarged veins (varices). When circulation through the portal vein is

> blocked, blood may back up into other blood vessels — mainly those in

> your

> stomach and esophagus. Sometimes veins also form around your navel and

> at

> the rectum. The blood vessels are thin-walled, and because they're

> filled

> with more blood than they're meant to carry, they're likely to bleed.

> Massive bleeding in the upper stomach or esophagus from these blood

> vessels is a life-threatening emergency that requires immediate medical

> care.

> Fluid retention. Liver disease can cause large amounts of fluid to

> accumulate in your legs (edema) and abdomen (ascites). Several factors

> play a role, including portal hypertension and changes in the hormones

> and

> chemicals that regulate fluids in your body. Ascites can be

> uncomfortable

> and may interfere with breathing and is usually a sign of advanced

> cirrhosis.

> Bruising and bleeding. Scarring of the liver (cirrhosis) interferes with

> the production of proteins that help your blood clot and with the

> absorption of vitamin K, which plays a role in synthesizing these

> proteins. As a result you may bruise and bleed more easily than normal.

> Bleeding in the gastrointestinal tract is particularly common.

> Mental changes. A damaged liver has trouble removing toxins from your

> body

> — normally one of the liver's key tasks. The buildup of toxins such as

> ammonia — a byproduct of protein digestion — can damage your brain,

> leading to changes in your mental state, behavior and personality

> (hepatic

> encephalopathy). Symptoms of hepatic encephalopathy include

> forgetfulness,

> confusion and mood changes.

> Liver failure. This occurs when extensive damage to liver cells makes it

> impossible for your liver to function. At this point, a liver transplant

> is the only option.

> Liver cancer. Cirrhosis is one of the most common causes of

> hepatocellular

> carcinoma, the main form of liver cancer.

> Treatment

>

> The goal in treating autoimmune hepatitis is to inhibit your body's

> autoimmune response and slow the progress of the disease. To achieve

> this,

> doctors usually prescribe an initial high dose of the corticosteroid

> drug

> prednisone, which suppresses the immune system. As soon as signs and

> symptoms improve, the medication is reduced to the lowest possible dose

> that controls the disease. Most people need to continue taking the drug

> for years, and sometimes for life. Although you may experience remission

> a

> few years after starting treatment, the disease usually returns when the

> drug is discontinued.

>

> Prednisone, especially when taken long term, can cause a wide range of

> serious side effects, including:

>

> Diabetes

> Thinning bones (osteoporosis)

> High blood pressure

> Glaucoma

> Difficulty fighting infection

> Thinning of your hair and skin

> Weight gain

> For that reason, azathioprine (Imuran), another immunosuppressant

> medication, is sometimes used along with prednisone. This helps lower

> the

> amount of prednisone needed, reducing its side effects. Azathioprine has

> risks of its own, however, including decreased resistance to infection,

> nausea, and in rare cases, liver damage and inflammation of the pancreas

> (pancreatitis).

>

> If you don't respond to these drugs or you have severe side effects,

> your

> doctor may prescribe cyclosporine or another immunosuppressant

> medication

> that may be effective. When medications don't halt the progress of the

> disease or you have or develop irreversible scarring (cirrhosis) or

> liver

> failure, the remaining option is a liver transplant — a procedure that's

> often very successful in people with autoimmune hepatitis.

>

>

> By Mayo Clinic Staff

> Feb 28, 2006

> © 1998-2007 Mayo Foundation for Medical Education and Research (MFMER).

> All rights reserved. A single copy of these materials may be reprinted

> for

> noncommercial personal use only. " Mayo, " " Mayo Clinic, "

> " MayoClinic.com, "

> " Embody Health, " " Reliable tools for healthier lives, " " Enhance your

> life, " and the triple-shield Mayo Clinic logo are trademarks of Mayo

> Foundation for Medical Education and Research.

> DS00676

>

>

>

> " and the beat goes on....... " Sonny Bono " It's not the years in your life

> that count. It's the life in your years. " Abraham Lincoln

>

> __________________________________________________

>

[Guest guest]

I could go on and on..... but this is no laughing matter and a much more

dangerous type of hep than hepc.... the amount of damage is absolutely

necessary and disease must be treated....... please please please listen

Anette..... love you dearly, sally

--- nmilover <nmilover@...> wrote:

> Original

> Article:http://www.mayoclinic.com/health/autoimmune-hepatitis/DS00676

> Autoimmune hepatitis

>

> Introduction

>

> A number of factors can cause the serious liver disease hepatitis,

> including viral infections, alcohol and certain drugs. But in autoimmune

> hepatitis, the problem is different: Your body's own immune system

> attacks

> your liver. Although the reason for this isn't entirely clear, some

> diseases, toxins and drugs may trigger autoimmune hepatitis in

> susceptible

> people, especially women.

>

> Untreated autoimmune hepatitis can lead to scarring of the liver

> (cirrhosis) and eventually to liver failure. When diagnosed and treated

> early, however, autoimmune hepatitis often can be controlled with drugs

> that suppress the immune system. Yet these medications, which often must

> be taken long term, carry a number of risks and aren't always effective.

> A

> liver transplant may be an option when autoimmune hepatitis doesn't

> respond to drug treatments or in cases of advanced liver disease.

>

> Signs and symptoms

>

> Signs and symptoms of autoimmune hepatitis can range from minor to

> severe

> and may come on suddenly or develop over time. Some people have few, if

> any, problems in the early stages of the disease, whereas others

> experience signs and symptoms that may include:

>

> Anemia

> Fatigue

> Abdominal discomfort

> Joint aches (arthralgias)

> Itching (pruritus)

> Yellowing of the skin and whites of the eyes (jaundice)

> An enlarged liver

> Abnormal blood vessels on the skin (spider angiomas)

> Nausea and vomiting

> Liver scarring (cirrhosis)

> Fluid in the abdomen (ascites) or mental confusion, in advanced cases

> It's common for people with autoimmune hepatitis to have other

> autoimmune

> disorders, such as:

>

> Hemolytic anemia, a type of anemia that occurs when red blood cells are

> destroyed faster than the bone marrow can replace them

> Chronic inflammation of the thyroid gland (thyroiditis)

> Inflammation of the colon (ulcerative colitis)

> Diabetes

> Dry eyes and mouth (Sjogren's syndrome)

> Causes

>

>

> CLICK TO ENLARGE

>

> The liver

>

> The liver is not only the largest internal organ in your body, it's also

> one of the hardest working and most complex. It performs hundreds of

> vital

> functions, including processing most nutrients, producing bile and

> blood-clotting factors, and removing drugs, alcohol and other harmful

> substances from your bloodstream. Because the constant exposure to a

> multitude of toxins can damage the liver and lead to hepatitis, many

> cases

> of hepatitis are alcohol or drug related.

>

> But in autoimmune hepatitis, the threat is much closer to home. The

> body's

> immune system, which ordinarily attacks viruses, bacteria and other

> pathogens, instead targets the liver, leading to chronic inflammation

> and

> increasingly serious damage to liver cells. Just why the body turns

> against itself is unclear, but autoimmune hepatitis appears to be

> triggered by:

>

> Infections. Autoimmune hepatitis can develop after a viral infection

> such

> as acute hepatitis A, hepatitis B, measles or Epstein-Barr virus

> infection. Epstein-Barr is one of the most common human viruses and

> linked

> to a number of disorders, including mononucleosis.

> Certain drugs. Some medications injure the liver directly — overdoses of

> the common pain reliever acetaminophen (Tylenol, others), for example,

> can

> cause liver failure. Other drugs harm the liver indirectly by

> stimulating

> an abnormal immune response that then harms liver cells. These drugs

> include interferon, which is commonly used to treat cancer, the high

> blood

> pressure medication methyldopa/hydrochlorothiazide (Aldoril),

> antibiotics

> such as minocycline — often used to treat adolescent acne — and

> nitrofurantoin, the anti-inflammatory diclofenac, and possibly the

> cholesterol drug atorvastatin (Lipitor).

> Genetic abnormalities. Some people seem genetically predisposed to

> develop

> autoimmune hepatitis. Researchers have identified certain gene deletions

> that increase the likelihood the disease will develop at a young age.

> Other genetic abnormalities may make autoimmune hepatitis more

> aggressive

> and harder to treat.

> Types of autoimmune hepatitis

> Doctors have identified two main forms of autoimmune hepatitis:

>

> Type 1 (classic) autoimmune hepatitis. Often developing suddenly, this

> is

> the most common type of the disease. Although it can occur in anyone at

> any age, most of those affected are young women. About half the people

> with type 1 autoimmune hepatitis have other autoimmune disorders such as

> thyroiditis, rheumatoid arthritis or ulcerative colitis. Their blood is

> also likely to contain antibodies against organ tissue.

> Type 2 autoimmune hepatitis. Although adults can develop type 2

> autoimmune

> hepatitis, it's most common in young girls and often occurs with other

> autoimmune problems. Researchers once thought that type 2 autoimmune

> hepatitis was more difficult to treat than type 1 is, but it now appears

> that both respond equally well to steroid therapy.

> Risk factors

>

> Autoimmune hepatitis is uncommon. Having one or more risk factors for

> the

> disease doesn't mean that you'll develop it — only that you may be more

> susceptible than someone without these risk factors:

>

> Your sex. Although both men and women can develop autoimmune hepatitis,

> the disease is far more common in women than it is in men.

> Age. Type 1 autoimmune hepatitis can occur in older adults, but it's

> most

> common in women between the ages of 15 and 40. Type 2 primarily affects

> young girls.

> A history of certain viral infections. Autoimmune hepatitis may develop

> after a viral infection, especially hepatitis A or B, measles, or

> infection with the Epstein-Barr virus.

> Use of certain medications. The high blood pressure drug

> methyldopa/hydrochlorothiazide (Aldoril), the anti-inflammatory

> diclofenac, the antibiotics minocycline and nitrofurantoin, and perhaps

> atorvastatin (Lipitor) may trigger autoimmune hepatitis in some people.

> Heredity. Certain genetic defects increase the risk of autoimmune

> hepatitis.

> When to seek medical advice

>

> Early signs and symptoms of autoimmune hepatitis can be mild and may

> resemble those of the flu. See your doctor if you have persistent

> fatigue,

> abdominal discomfort or joint aches unrelated to exercise. More serious

> symptoms, such as yellowing of your skin and the whites of your eyes or

> abdominal swelling, require immediate care, especially if you have risk

> factors for autoimmune hepatitis.

>

> Screening and diagnosis

>

> Although your symptoms can alert your doctor to the possibility of liver

> disease, you'll need certain tests to diagnose autoimmune hepatitis.

> These

> include:

>

> Blood tests. Antibody tests can distinguish autoimmune hepatitis from

> viral hepatitis and other disorders with similar symptoms. They also

> help

> pinpoint the type of autoimmune hepatitis you have. Antibodies are

> immune

> system proteins that normally attack harmful viruses and bacteria. But

> in

> autoimmune hepatitis, the antibodies attack the liver.

> Liver biopsy. Doctors perform this test to confirm the diagnosis and to

> determine the degree and type of liver damage. During the procedure, a

> small amount of liver tissue is removed, using a thin needle that's

> passed

> into your liver through a small incision in your skin. The sample is

> then

> sent to a laboratory for analysis.

> Imaging tests. An abdominal ultrasound or abdominal computerized

> tomography (CT) scan can't diagnose autoimmune hepatitis, but doctors

> sometimes use imaging tests to rule out liver cancer, a complication of

> cirrhosis.

> Complications

>

> Autoimmune hepatitis can cause a variety of complications, including:

>

> Pernicious anemia. Associated with a number of autoimmune disorders,

> pernicious anemia occurs when a lack of vitamin B12 interferes with your

> body's ability to form red blood cells. Signs and symptoms of pernicious

> anemia can range from shortness of breath and a rapid heart rate to

> diarrhea, numbness or tingling in your hands and feet, and personality

> changes.

> Hemolytic anemia. In this type of anemia, your immune system attacks and

> breaks down red blood cells faster than your bone marrow can replace

> them.

> Thrombocytopenic purpura. Platelets are blood cells that play a crucial

> role in blood clotting. In thrombocytopenic purpura, your immune system

> attacks and destroys these cells, leading to easy bruising and bleeding.

> Ulcerative colitis. This inflammatory bowel disease can cause severe

> bouts

> of watery or bloody diarrhea and abdominal pain. It occurs in as many as

> three in 10 people with type 1 autoimmune hepatitis.

> Celiac disease. This disease causes an abnormal reaction to gluten, a

> protein found in most grains. Eating gluten sets off an immune response

> that damages the surface of the small intestine, affecting the

> intestine's

> ability to absorb nutrients from food.

> Autoimmune thyroiditis (Hashimoto's thyroiditis). In this condition, the

> immune system attacks the thyroid gland. In some people this causes the

> gland to secrete too little thyroid hormone (hypothyroidism); in others,

> the gland produces too much hormone (hyperthyroidism) and then produces

> too little.

> Type 1 diabetes. In type 1 diabetes, the immune system targets and

> destroys the insulin-producing cells in the pancreas. Insulin plays a

> vital role in making glucose — the body's fuel — available to cells.

> Without insulin, cells starve, and glucose builds up in the bloodstream.

> Diabetes is a serious illness that can damage organs throughout the

> body.

> Rheumatoid arthritis. Another autoimmune disease, rheumatoid arthritis

> occurs when the immune system attacks the lining of your joints, leading

> to stiffness, pain, swelling, and sometimes to deformity and disability.

> Because symptoms don't always appear in the early stages of the disease,

> some people with autoimmune hepatitis develop irreversible scarring of

> liver tissue (cirrhosis) before they're ever diagnosed. Complications of

> cirrhosis include:

>

> Increased blood pressure in the vein from the liver. Blood from your

> intestine, spleen and pancreas enters your liver through a large blood

> vessel called the portal vein. If scar tissue blocks normal circulation

> through your liver, this blood backs up, leading to increased pressure

> within the portal vein (portal hypertension).

> Enlarged veins (varices). When circulation through the portal vein is

> blocked, blood may back up into other blood vessels — mainly those in

> your

> stomach and esophagus. Sometimes veins also form around your navel and

> at

> the rectum. The blood vessels are thin-walled, and because they're

> filled

> with more blood than they're meant to carry, they're likely to bleed.

> Massive bleeding in the upper stomach or esophagus from these blood

> vessels is a life-threatening emergency that requires immediate medical

> care.

> Fluid retention. Liver disease can cause large amounts of fluid to

> accumulate in your legs (edema) and abdomen (ascites). Several factors

> play a role, including portal hypertension and changes in the hormones

> and

> chemicals that regulate fluids in your body. Ascites can be

> uncomfortable

> and may interfere with breathing and is usually a sign of advanced

> cirrhosis.

> Bruising and bleeding. Scarring of the liver (cirrhosis) interferes with

> the production of proteins that help your blood clot and with the

> absorption of vitamin K, which plays a role in synthesizing these

> proteins. As a result you may bruise and bleed more easily than normal.

> Bleeding in the gastrointestinal tract is particularly common.

> Mental changes. A damaged liver has trouble removing toxins from your

> body

> — normally one of the liver's key tasks. The buildup of toxins such as

> ammonia — a byproduct of protein digestion — can damage your brain,

> leading to changes in your mental state, behavior and personality

> (hepatic

> encephalopathy). Symptoms of hepatic encephalopathy include

> forgetfulness,

> confusion and mood changes.

> Liver failure. This occurs when extensive damage to liver cells makes it

> impossible for your liver to function. At this point, a liver transplant

> is the only option.

> Liver cancer. Cirrhosis is one of the most common causes of

> hepatocellular

> carcinoma, the main form of liver cancer.

> Treatment

>

> The goal in treating autoimmune hepatitis is to inhibit your body's

> autoimmune response and slow the progress of the disease. To achieve

> this,

> doctors usually prescribe an initial high dose of the corticosteroid

> drug

> prednisone, which suppresses the immune system. As soon as signs and

> symptoms improve, the medication is reduced to the lowest possible dose

> that controls the disease. Most people need to continue taking the drug

> for years, and sometimes for life. Although you may experience remission

> a

> few years after starting treatment, the disease usually returns when the

> drug is discontinued.

>

> Prednisone, especially when taken long term, can cause a wide range of

> serious side effects, including:

>

> Diabetes

> Thinning bones (osteoporosis)

> High blood pressure

> Glaucoma

> Difficulty fighting infection

> Thinning of your hair and skin

> Weight gain

> For that reason, azathioprine (Imuran), another immunosuppressant

> medication, is sometimes used along with prednisone. This helps lower

> the

> amount of prednisone needed, reducing its side effects. Azathioprine has

> risks of its own, however, including decreased resistance to infection,

> nausea, and in rare cases, liver damage and inflammation of the pancreas

> (pancreatitis).

>

> If you don't respond to these drugs or you have severe side effects,

> your

> doctor may prescribe cyclosporine or another immunosuppressant

> medication

> that may be effective. When medications don't halt the progress of the

> disease or you have or develop irreversible scarring (cirrhosis) or

> liver

> failure, the remaining option is a liver transplant — a procedure that's

> often very successful in people with autoimmune hepatitis.

>

>

> By Mayo Clinic Staff

> Feb 28, 2006

> © 1998-2007 Mayo Foundation for Medical Education and Research (MFMER).

> All rights reserved. A single copy of these materials may be reprinted

> for

> noncommercial personal use only. " Mayo, " " Mayo Clinic, "

> " MayoClinic.com, "

> " Embody Health, " " Reliable tools for healthier lives, " " Enhance your

> life, " and the triple-shield Mayo Clinic logo are trademarks of Mayo

> Foundation for Medical Education and Research.

> DS00676

>

>

>

> " and the beat goes on....... " Sonny Bono " It's not the years in your life

> that count. It's the life in your years. " Abraham Lincoln

>

> __________________________________________________

>

[Guest guest]

I could go on and on..... but this is no laughing matter and a much more

dangerous type of hep than hepc.... the amount of damage is absolutely

necessary and disease must be treated....... please please please listen

Anette..... love you dearly, sally

--- nmilover <nmilover@...> wrote:

> Original

> Article:http://www.mayoclinic.com/health/autoimmune-hepatitis/DS00676

> Autoimmune hepatitis

>

> Introduction

>

> A number of factors can cause the serious liver disease hepatitis,

> including viral infections, alcohol and certain drugs. But in autoimmune

> hepatitis, the problem is different: Your body's own immune system

> attacks

> your liver. Although the reason for this isn't entirely clear, some

> diseases, toxins and drugs may trigger autoimmune hepatitis in

> susceptible

> people, especially women.

>

> Untreated autoimmune hepatitis can lead to scarring of the liver

> (cirrhosis) and eventually to liver failure. When diagnosed and treated

> early, however, autoimmune hepatitis often can be controlled with drugs

> that suppress the immune system. Yet these medications, which often must

> be taken long term, carry a number of risks and aren't always effective.

> A

> liver transplant may be an option when autoimmune hepatitis doesn't

> respond to drug treatments or in cases of advanced liver disease.

>

> Signs and symptoms

>

> Signs and symptoms of autoimmune hepatitis can range from minor to

> severe

> and may come on suddenly or develop over time. Some people have few, if

> any, problems in the early stages of the disease, whereas others

> experience signs and symptoms that may include:

>

> Anemia

> Fatigue

> Abdominal discomfort

> Joint aches (arthralgias)

> Itching (pruritus)

> Yellowing of the skin and whites of the eyes (jaundice)

> An enlarged liver

> Abnormal blood vessels on the skin (spider angiomas)

> Nausea and vomiting

> Liver scarring (cirrhosis)

> Fluid in the abdomen (ascites) or mental confusion, in advanced cases

> It's common for people with autoimmune hepatitis to have other

> autoimmune

> disorders, such as:

>

> Hemolytic anemia, a type of anemia that occurs when red blood cells are

> destroyed faster than the bone marrow can replace them

> Chronic inflammation of the thyroid gland (thyroiditis)

> Inflammation of the colon (ulcerative colitis)

> Diabetes

> Dry eyes and mouth (Sjogren's syndrome)

> Causes

>

>

> CLICK TO ENLARGE

>

> The liver

>

> The liver is not only the largest internal organ in your body, it's also

> one of the hardest working and most complex. It performs hundreds of

> vital

> functions, including processing most nutrients, producing bile and

> blood-clotting factors, and removing drugs, alcohol and other harmful

> substances from your bloodstream. Because the constant exposure to a

> multitude of toxins can damage the liver and lead to hepatitis, many

> cases

> of hepatitis are alcohol or drug related.

>

> But in autoimmune hepatitis, the threat is much closer to home. The

> body's

> immune system, which ordinarily attacks viruses, bacteria and other

> pathogens, instead targets the liver, leading to chronic inflammation

> and

> increasingly serious damage to liver cells. Just why the body turns

> against itself is unclear, but autoimmune hepatitis appears to be

> triggered by:

>

> Infections. Autoimmune hepatitis can develop after a viral infection

> such

> as acute hepatitis A, hepatitis B, measles or Epstein-Barr virus

> infection. Epstein-Barr is one of the most common human viruses and

> linked

> to a number of disorders, including mononucleosis.

> Certain drugs. Some medications injure the liver directly — overdoses of

> the common pain reliever acetaminophen (Tylenol, others), for example,

> can

> cause liver failure. Other drugs harm the liver indirectly by

> stimulating

> an abnormal immune response that then harms liver cells. These drugs

> include interferon, which is commonly used to treat cancer, the high

> blood

> pressure medication methyldopa/hydrochlorothiazide (Aldoril),

> antibiotics

> such as minocycline — often used to treat adolescent acne — and

> nitrofurantoin, the anti-inflammatory diclofenac, and possibly the

> cholesterol drug atorvastatin (Lipitor).

> Genetic abnormalities. Some people seem genetically predisposed to

> develop

> autoimmune hepatitis. Researchers have identified certain gene deletions

> that increase the likelihood the disease will develop at a young age.

> Other genetic abnormalities may make autoimmune hepatitis more

> aggressive

> and harder to treat.

> Types of autoimmune hepatitis

> Doctors have identified two main forms of autoimmune hepatitis:

>

> Type 1 (classic) autoimmune hepatitis. Often developing suddenly, this

> is

> the most common type of the disease. Although it can occur in anyone at

> any age, most of those affected are young women. About half the people

> with type 1 autoimmune hepatitis have other autoimmune disorders such as

> thyroiditis, rheumatoid arthritis or ulcerative colitis. Their blood is

> also likely to contain antibodies against organ tissue.

> Type 2 autoimmune hepatitis. Although adults can develop type 2

> autoimmune

> hepatitis, it's most common in young girls and often occurs with other

> autoimmune problems. Researchers once thought that type 2 autoimmune

> hepatitis was more difficult to treat than type 1 is, but it now appears

> that both respond equally well to steroid therapy.

> Risk factors

>

> Autoimmune hepatitis is uncommon. Having one or more risk factors for

> the

> disease doesn't mean that you'll develop it — only that you may be more

> susceptible than someone without these risk factors:

>

> Your sex. Although both men and women can develop autoimmune hepatitis,

> the disease is far more common in women than it is in men.

> Age. Type 1 autoimmune hepatitis can occur in older adults, but it's

> most

> common in women between the ages of 15 and 40. Type 2 primarily affects

> young girls.

> A history of certain viral infections. Autoimmune hepatitis may develop

> after a viral infection, especially hepatitis A or B, measles, or

> infection with the Epstein-Barr virus.

> Use of certain medications. The high blood pressure drug

> methyldopa/hydrochlorothiazide (Aldoril), the anti-inflammatory

> diclofenac, the antibiotics minocycline and nitrofurantoin, and perhaps

> atorvastatin (Lipitor) may trigger autoimmune hepatitis in some people.

> Heredity. Certain genetic defects increase the risk of autoimmune

> hepatitis.

> When to seek medical advice

>

> Early signs and symptoms of autoimmune hepatitis can be mild and may

> resemble those of the flu. See your doctor if you have persistent

> fatigue,

> abdominal discomfort or joint aches unrelated to exercise. More serious

> symptoms, such as yellowing of your skin and the whites of your eyes or

> abdominal swelling, require immediate care, especially if you have risk

> factors for autoimmune hepatitis.

>

> Screening and diagnosis

>

> Although your symptoms can alert your doctor to the possibility of liver

> disease, you'll need certain tests to diagnose autoimmune hepatitis.

> These

> include:

>

> Blood tests. Antibody tests can distinguish autoimmune hepatitis from

> viral hepatitis and other disorders with similar symptoms. They also

> help

> pinpoint the type of autoimmune hepatitis you have. Antibodies are

> immune

> system proteins that normally attack harmful viruses and bacteria. But

> in

> autoimmune hepatitis, the antibodies attack the liver.

> Liver biopsy. Doctors perform this test to confirm the diagnosis and to

> determine the degree and type of liver damage. During the procedure, a

> small amount of liver tissue is removed, using a thin needle that's

> passed

> into your liver through a small incision in your skin. The sample is

> then

> sent to a laboratory for analysis.

> Imaging tests. An abdominal ultrasound or abdominal computerized

> tomography (CT) scan can't diagnose autoimmune hepatitis, but doctors

> sometimes use imaging tests to rule out liver cancer, a complication of

> cirrhosis.

> Complications

>

> Autoimmune hepatitis can cause a variety of complications, including:

>

> Pernicious anemia. Associated with a number of autoimmune disorders,

> pernicious anemia occurs when a lack of vitamin B12 interferes with your

> body's ability to form red blood cells. Signs and symptoms of pernicious

> anemia can range from shortness of breath and a rapid heart rate to

> diarrhea, numbness or tingling in your hands and feet, and personality

> changes.

> Hemolytic anemia. In this type of anemia, your immune system attacks and

> breaks down red blood cells faster than your bone marrow can replace

> them.

> Thrombocytopenic purpura. Platelets are blood cells that play a crucial

> role in blood clotting. In thrombocytopenic purpura, your immune system

> attacks and destroys these cells, leading to easy bruising and bleeding.

> Ulcerative colitis. This inflammatory bowel disease can cause severe

> bouts

> of watery or bloody diarrhea and abdominal pain. It occurs in as many as

> three in 10 people with type 1 autoimmune hepatitis.

> Celiac disease. This disease causes an abnormal reaction to gluten, a

> protein found in most grains. Eating gluten sets off an immune response

> that damages the surface of the small intestine, affecting the

> intestine's

> ability to absorb nutrients from food.

> Autoimmune thyroiditis (Hashimoto's thyroiditis). In this condition, the

> immune system attacks the thyroid gland. In some people this causes the

> gland to secrete too little thyroid hormone (hypothyroidism); in others,

> the gland produces too much hormone (hyperthyroidism) and then produces

> too little.

> Type 1 diabetes. In type 1 diabetes, the immune system targets and

> destroys the insulin-producing cells in the pancreas. Insulin plays a

> vital role in making glucose — the body's fuel — available to cells.

> Without insulin, cells starve, and glucose builds up in the bloodstream.

> Diabetes is a serious illness that can damage organs throughout the

> body.

> Rheumatoid arthritis. Another autoimmune disease, rheumatoid arthritis

> occurs when the immune system attacks the lining of your joints, leading

> to stiffness, pain, swelling, and sometimes to deformity and disability.

> Because symptoms don't always appear in the early stages of the disease,

> some people with autoimmune hepatitis develop irreversible scarring of

> liver tissue (cirrhosis) before they're ever diagnosed. Complications of

> cirrhosis include:

>

> Increased blood pressure in the vein from the liver. Blood from your

> intestine, spleen and pancreas enters your liver through a large blood

> vessel called the portal vein. If scar tissue blocks normal circulation

> through your liver, this blood backs up, leading to increased pressure

> within the portal vein (portal hypertension).

> Enlarged veins (varices). When circulation through the portal vein is

> blocked, blood may back up into other blood vessels — mainly those in

> your

> stomach and esophagus. Sometimes veins also form around your navel and

> at

> the rectum. The blood vessels are thin-walled, and because they're

> filled

> with more blood than they're meant to carry, they're likely to bleed.

> Massive bleeding in the upper stomach or esophagus from these blood

> vessels is a life-threatening emergency that requires immediate medical

> care.

> Fluid retention. Liver disease can cause large amounts of fluid to

> accumulate in your legs (edema) and abdomen (ascites). Several factors

> play a role, including portal hypertension and changes in the hormones

> and

> chemicals that regulate fluids in your body. Ascites can be

> uncomfortable

> and may interfere with breathing and is usually a sign of advanced

> cirrhosis.

> Bruising and bleeding. Scarring of the liver (cirrhosis) interferes with

> the production of proteins that help your blood clot and with the

> absorption of vitamin K, which plays a role in synthesizing these

> proteins. As a result you may bruise and bleed more easily than normal.

> Bleeding in the gastrointestinal tract is particularly common.

> Mental changes. A damaged liver has trouble removing toxins from your

> body

> — normally one of the liver's key tasks. The buildup of toxins such as

> ammonia — a byproduct of protein digestion — can damage your brain,

> leading to changes in your mental state, behavior and personality

> (hepatic

> encephalopathy). Symptoms of hepatic encephalopathy include

> forgetfulness,

> confusion and mood changes.

> Liver failure. This occurs when extensive damage to liver cells makes it

> impossible for your liver to function. At this point, a liver transplant

> is the only option.

> Liver cancer. Cirrhosis is one of the most common causes of

> hepatocellular

> carcinoma, the main form of liver cancer.

> Treatment

>

> The goal in treating autoimmune hepatitis is to inhibit your body's

> autoimmune response and slow the progress of the disease. To achieve

> this,

> doctors usually prescribe an initial high dose of the corticosteroid

> drug

> prednisone, which suppresses the immune system. As soon as signs and

> symptoms improve, the medication is reduced to the lowest possible dose

> that controls the disease. Most people need to continue taking the drug

> for years, and sometimes for life. Although you may experience remission

> a

> few years after starting treatment, the disease usually returns when the

> drug is discontinued.

>

> Prednisone, especially when taken long term, can cause a wide range of

> serious side effects, including:

>

> Diabetes

> Thinning bones (osteoporosis)

> High blood pressure

> Glaucoma

> Difficulty fighting infection

> Thinning of your hair and skin

> Weight gain

> For that reason, azathioprine (Imuran), another immunosuppressant

> medication, is sometimes used along with prednisone. This helps lower

> the

> amount of prednisone needed, reducing its side effects. Azathioprine has

> risks of its own, however, including decreased resistance to infection,

> nausea, and in rare cases, liver damage and inflammation of the pancreas

> (pancreatitis).

>

> If you don't respond to these drugs or you have severe side effects,

> your

> doctor may prescribe cyclosporine or another immunosuppressant

> medication

> that may be effective. When medications don't halt the progress of the

> disease or you have or develop irreversible scarring (cirrhosis) or

> liver

> failure, the remaining option is a liver transplant — a procedure that's

> often very successful in people with autoimmune hepatitis.

>

>

> By Mayo Clinic Staff

> Feb 28, 2006

> © 1998-2007 Mayo Foundation for Medical Education and Research (MFMER).

> All rights reserved. A single copy of these materials may be reprinted

> for

> noncommercial personal use only. " Mayo, " " Mayo Clinic, "

> " MayoClinic.com, "

> " Embody Health, " " Reliable tools for healthier lives, " " Enhance your

> life, " and the triple-shield Mayo Clinic logo are trademarks of Mayo

> Foundation for Medical Education and Research.

> DS00676

>

>

>

> " and the beat goes on....... " Sonny Bono " It's not the years in your life

> that count. It's the life in your years. " Abraham Lincoln

>

> __________________________________________________

>

[Guest guest]

I could go on and on..... but this is no laughing matter and a much more

dangerous type of hep than hepc.... the amount of damage is absolutely

necessary and disease must be treated....... please please please listen

Anette..... love you dearly, sally

--- nmilover <nmilover@...> wrote:

> Original

> Article:http://www.mayoclinic.com/health/autoimmune-hepatitis/DS00676

> Autoimmune hepatitis

>

> Introduction

>

> A number of factors can cause the serious liver disease hepatitis,

> including viral infections, alcohol and certain drugs. But in autoimmune

> hepatitis, the problem is different: Your body's own immune system

> attacks

> your liver. Although the reason for this isn't entirely clear, some

> diseases, toxins and drugs may trigger autoimmune hepatitis in

> susceptible

> people, especially women.

>

> Untreated autoimmune hepatitis can lead to scarring of the liver

> (cirrhosis) and eventually to liver failure. When diagnosed and treated

> early, however, autoimmune hepatitis often can be controlled with drugs

> that suppress the immune system. Yet these medications, which often must

> be taken long term, carry a number of risks and aren't always effective.

> A

> liver transplant may be an option when autoimmune hepatitis doesn't

> respond to drug treatments or in cases of advanced liver disease.

>

> Signs and symptoms

>

> Signs and symptoms of autoimmune hepatitis can range from minor to

> severe

> and may come on suddenly or develop over time. Some people have few, if

> any, problems in the early stages of the disease, whereas others

> experience signs and symptoms that may include:

>

> Anemia

> Fatigue

> Abdominal discomfort

> Joint aches (arthralgias)

> Itching (pruritus)

> Yellowing of the skin and whites of the eyes (jaundice)

> An enlarged liver

> Abnormal blood vessels on the skin (spider angiomas)

> Nausea and vomiting

> Liver scarring (cirrhosis)

> Fluid in the abdomen (ascites) or mental confusion, in advanced cases

> It's common for people with autoimmune hepatitis to have other

> autoimmune

> disorders, such as:

>

> Hemolytic anemia, a type of anemia that occurs when red blood cells are

> destroyed faster than the bone marrow can replace them

> Chronic inflammation of the thyroid gland (thyroiditis)

> Inflammation of the colon (ulcerative colitis)

> Diabetes

> Dry eyes and mouth (Sjogren's syndrome)

> Causes

>

>

> CLICK TO ENLARGE

>

> The liver

>

> The liver is not only the largest internal organ in your body, it's also

> one of the hardest working and most complex. It performs hundreds of

> vital

> functions, including processing most nutrients, producing bile and

> blood-clotting factors, and removing drugs, alcohol and other harmful

> substances from your bloodstream. Because the constant exposure to a

> multitude of toxins can damage the liver and lead to hepatitis, many

> cases

> of hepatitis are alcohol or drug related.

>

> But in autoimmune hepatitis, the threat is much closer to home. The

> body's

> immune system, which ordinarily attacks viruses, bacteria and other

> pathogens, instead targets the liver, leading to chronic inflammation

> and

> increasingly serious damage to liver cells. Just why the body turns

> against itself is unclear, but autoimmune hepatitis appears to be

> triggered by:

>

> Infections. Autoimmune hepatitis can develop after a viral infection

> such

> as acute hepatitis A, hepatitis B, measles or Epstein-Barr virus

> infection. Epstein-Barr is one of the most common human viruses and

> linked

> to a number of disorders, including mononucleosis.

> Certain drugs. Some medications injure the liver directly — overdoses of

> the common pain reliever acetaminophen (Tylenol, others), for example,

> can

> cause liver failure. Other drugs harm the liver indirectly by

> stimulating

> an abnormal immune response that then harms liver cells. These drugs

> include interferon, which is commonly used to treat cancer, the high

> blood

> pressure medication methyldopa/hydrochlorothiazide (Aldoril),

> antibiotics

> such as minocycline — often used to treat adolescent acne — and

> nitrofurantoin, the anti-inflammatory diclofenac, and possibly the

> cholesterol drug atorvastatin (Lipitor).

> Genetic abnormalities. Some people seem genetically predisposed to

> develop

> autoimmune hepatitis. Researchers have identified certain gene deletions

> that increase the likelihood the disease will develop at a young age.

> Other genetic abnormalities may make autoimmune hepatitis more

> aggressive

> and harder to treat.

> Types of autoimmune hepatitis

> Doctors have identified two main forms of autoimmune hepatitis:

>

> Type 1 (classic) autoimmune hepatitis. Often developing suddenly, this

> is

> the most common type of the disease. Although it can occur in anyone at

> any age, most of those affected are young women. About half the people

> with type 1 autoimmune hepatitis have other autoimmune disorders such as

> thyroiditis, rheumatoid arthritis or ulcerative colitis. Their blood is

> also likely to contain antibodies against organ tissue.

> Type 2 autoimmune hepatitis. Although adults can develop type 2

> autoimmune

> hepatitis, it's most common in young girls and often occurs with other

> autoimmune problems. Researchers once thought that type 2 autoimmune

> hepatitis was more difficult to treat than type 1 is, but it now appears

> that both respond equally well to steroid therapy.

> Risk factors

>

> Autoimmune hepatitis is uncommon. Having one or more risk factors for

> the

> disease doesn't mean that you'll develop it — only that you may be more

> susceptible than someone without these risk factors:

>

> Your sex. Although both men and women can develop autoimmune hepatitis,

> the disease is far more common in women than it is in men.

> Age. Type 1 autoimmune hepatitis can occur in older adults, but it's

> most

> common in women between the ages of 15 and 40. Type 2 primarily affects

> young girls.

> A history of certain viral infections. Autoimmune hepatitis may develop

> after a viral infection, especially hepatitis A or B, measles, or

> infection with the Epstein-Barr virus.

> Use of certain medications. The high blood pressure drug

> methyldopa/hydrochlorothiazide (Aldoril), the anti-inflammatory

> diclofenac, the antibiotics minocycline and nitrofurantoin, and perhaps

> atorvastatin (Lipitor) may trigger autoimmune hepatitis in some people.

> Heredity. Certain genetic defects increase the risk of autoimmune

> hepatitis.

> When to seek medical advice

>

> Early signs and symptoms of autoimmune hepatitis can be mild and may

> resemble those of the flu. See your doctor if you have persistent

> fatigue,

> abdominal discomfort or joint aches unrelated to exercise. More serious

> symptoms, such as yellowing of your skin and the whites of your eyes or

> abdominal swelling, require immediate care, especially if you have risk

> factors for autoimmune hepatitis.

>

> Screening and diagnosis

>

> Although your symptoms can alert your doctor to the possibility of liver

> disease, you'll need certain tests to diagnose autoimmune hepatitis.

> These

> include:

>

> Blood tests. Antibody tests can distinguish autoimmune hepatitis from

> viral hepatitis and other disorders with similar symptoms. They also

> help

> pinpoint the type of autoimmune hepatitis you have. Antibodies are

> immune

> system proteins that normally attack harmful viruses and bacteria. But

> in

> autoimmune hepatitis, the antibodies attack the liver.

> Liver biopsy. Doctors perform this test to confirm the diagnosis and to

> determine the degree and type of liver damage. During the procedure, a

> small amount of liver tissue is removed, using a thin needle that's

> passed

> into your liver through a small incision in your skin. The sample is

> then

> sent to a laboratory for analysis.

> Imaging tests. An abdominal ultrasound or abdominal computerized

> tomography (CT) scan can't diagnose autoimmune hepatitis, but doctors

> sometimes use imaging tests to rule out liver cancer, a complication of

> cirrhosis.

> Complications

>

> Autoimmune hepatitis can cause a variety of complications, including:

>

> Pernicious anemia. Associated with a number of autoimmune disorders,

> pernicious anemia occurs when a lack of vitamin B12 interferes with your

> body's ability to form red blood cells. Signs and symptoms of pernicious

> anemia can range from shortness of breath and a rapid heart rate to

> diarrhea, numbness or tingling in your hands and feet, and personality

> changes.

> Hemolytic anemia. In this type of anemia, your immune system attacks and

> breaks down red blood cells faster than your bone marrow can replace

> them.

> Thrombocytopenic purpura. Platelets are blood cells that play a crucial

> role in blood clotting. In thrombocytopenic purpura, your immune system

> attacks and destroys these cells, leading to easy bruising and bleeding.

> Ulcerative colitis. This inflammatory bowel disease can cause severe

> bouts

> of watery or bloody diarrhea and abdominal pain. It occurs in as many as

> three in 10 people with type 1 autoimmune hepatitis.

> Celiac disease. This disease causes an abnormal reaction to gluten, a

> protein found in most grains. Eating gluten sets off an immune response

> that damages the surface of the small intestine, affecting the

> intestine's

> ability to absorb nutrients from food.

> Autoimmune thyroiditis (Hashimoto's thyroiditis). In this condition, the

> immune system attacks the thyroid gland. In some people this causes the

> gland to secrete too little thyroid hormone (hypothyroidism); in others,

> the gland produces too much hormone (hyperthyroidism) and then produces

> too little.

> Type 1 diabetes. In type 1 diabetes, the immune system targets and

> destroys the insulin-producing cells in the pancreas. Insulin plays a

> vital role in making glucose — the body's fuel — available to cells.

> Without insulin, cells starve, and glucose builds up in the bloodstream.

> Diabetes is a serious illness that can damage organs throughout the

> body.

> Rheumatoid arthritis. Another autoimmune disease, rheumatoid arthritis

> occurs when the immune system attacks the lining of your joints, leading

> to stiffness, pain, swelling, and sometimes to deformity and disability.

> Because symptoms don't always appear in the early stages of the disease,

> some people with autoimmune hepatitis develop irreversible scarring of

> liver tissue (cirrhosis) before they're ever diagnosed. Complications of

> cirrhosis include:

>

> Increased blood pressure in the vein from the liver. Blood from your

> intestine, spleen and pancreas enters your liver through a large blood

> vessel called the portal vein. If scar tissue blocks normal circulation

> through your liver, this blood backs up, leading to increased pressure

> within the portal vein (portal hypertension).

> Enlarged veins (varices). When circulation through the portal vein is

> blocked, blood may back up into other blood vessels — mainly those in

> your

> stomach and esophagus. Sometimes veins also form around your navel and

> at

> the rectum. The blood vessels are thin-walled, and because they're

> filled

> with more blood than they're meant to carry, they're likely to bleed.

> Massive bleeding in the upper stomach or esophagus from these blood

> vessels is a life-threatening emergency that requires immediate medical

> care.

> Fluid retention. Liver disease can cause large amounts of fluid to

> accumulate in your legs (edema) and abdomen (ascites). Several factors

> play a role, including portal hypertension and changes in the hormones

> and

> chemicals that regulate fluids in your body. Ascites can be

> uncomfortable

> and may interfere with breathing and is usually a sign of advanced

> cirrhosis.

> Bruising and bleeding. Scarring of the liver (cirrhosis) interferes with

> the production of proteins that help your blood clot and with the

> absorption of vitamin K, which plays a role in synthesizing these

> proteins. As a result you may bruise and bleed more easily than normal.

> Bleeding in the gastrointestinal tract is particularly common.

> Mental changes. A damaged liver has trouble removing toxins from your

> body

> — normally one of the liver's key tasks. The buildup of toxins such as

> ammonia — a byproduct of protein digestion — can damage your brain,

> leading to changes in your mental state, behavior and personality

> (hepatic

> encephalopathy). Symptoms of hepatic encephalopathy include

> forgetfulness,

> confusion and mood changes.

> Liver failure. This occurs when extensive damage to liver cells makes it

> impossible for your liver to function. At this point, a liver transplant

> is the only option.

> Liver cancer. Cirrhosis is one of the most common causes of

> hepatocellular

> carcinoma, the main form of liver cancer.

> Treatment

>

> The goal in treating autoimmune hepatitis is to inhibit your body's

> autoimmune response and slow the progress of the disease. To achieve

> this,

> doctors usually prescribe an initial high dose of the corticosteroid

> drug

> prednisone, which suppresses the immune system. As soon as signs and

> symptoms improve, the medication is reduced to the lowest possible dose

> that controls the disease. Most people need to continue taking the drug

> for years, and sometimes for life. Although you may experience remission

> a

> few years after starting treatment, the disease usually returns when the

> drug is discontinued.

>

> Prednisone, especially when taken long term, can cause a wide range of

> serious side effects, including:

>

> Diabetes

> Thinning bones (osteoporosis)

> High blood pressure

> Glaucoma

> Difficulty fighting infection

> Thinning of your hair and skin

> Weight gain

> For that reason, azathioprine (Imuran), another immunosuppressant

> medication, is sometimes used along with prednisone. This helps lower

> the

> amount of prednisone needed, reducing its side effects. Azathioprine has

> risks of its own, however, including decreased resistance to infection,

> nausea, and in rare cases, liver damage and inflammation of the pancreas

> (pancreatitis).

>

> If you don't respond to these drugs or you have severe side effects,

> your

> doctor may prescribe cyclosporine or another immunosuppressant

> medication

> that may be effective. When medications don't halt the progress of the

> disease or you have or develop irreversible scarring (cirrhosis) or

> liver

> failure, the remaining option is a liver transplant — a procedure that's

> often very successful in people with autoimmune hepatitis.

>

>

> By Mayo Clinic Staff

> Feb 28, 2006

> © 1998-2007 Mayo Foundation for Medical Education and Research (MFMER).

> All rights reserved. A single copy of these materials may be reprinted

> for

> noncommercial personal use only. " Mayo, " " Mayo Clinic, "

> " MayoClinic.com, "

> " Embody Health, " " Reliable tools for healthier lives, " " Enhance your

> life, " and the triple-shield Mayo Clinic logo are trademarks of Mayo

> Foundation for Medical Education and Research.

> DS00676

>

>

>

> " and the beat goes on....... " Sonny Bono " It's not the years in your life

> that count. It's the life in your years. " Abraham Lincoln

>

> __________________________________________________

>