Autoimmune hepatitis is a disease that causes chronic inflammation of the liver due to a change in the immune system, which starts to recognize its own cells as foreign and attacks them, causing a decrease in liver function and the appearance of symptoms such as abdominal pain, yellowish skin and strong nausea.
Autoimmune hepatitis usually appears before age 30 and is more common in women. The exact cause of the onset of this disease, which is probably related to genetic alterations, is not yet known, but it must be remembered that it is not a contagious disease and, therefore, it cannot be transmitted from one person to another.
In addition, autoimmune hepatitis can be divided into three subtypes:
- Type 1 autoimmune hepatitis: most common between 16 and 30 years old, being characterized by the presence of FAN and AML antibodies in the blood test, and may be associated with the appearance of other autoimmune diseases, such as thyroiditis, celiac disease, synovitis and ulcerative colitis; Type 2 autoimmune hepatitis: usually occurs in children aged 2 to 14 years, the characteristic antibody is Anti-LKM1, and can occur in conjunction with type 1 diabetes, vitiligo and autoimmune thyroiditis;
Type 3 autoimmune hepatitis: similar to type 1 autoimmune hepatitis, with positive anti-SLA / LP antibody, but possibly more severe than type 1.
Although there is no cure, autoimmune hepatitis can be very well controlled with the treatment, which is done with medications to control immunity, such as Prednisone and Azathioprine, in addition to a balanced diet, rich in fruits, vegetables and cereals, being indicated, avoiding consumption of alcohol, fats, excess preservatives and pesticides. Surgery or liver transplantation is only indicated in very severe cases.
Main symptoms
The symptoms of autoimmune hepatitis are usually nonspecific and the clinical picture can vary from an asymptomatic patient to the occurrence of liver failure. Thus, the main signs and symptoms that may indicate autoimmune hepatitis are:
- Excessive tiredness; Loss of appetite; Muscle pain; Constant abdominal pain; Nausea and vomiting; Yellowish skin and eyes, also called jaundice; Mild itching on the body; Joint pain; Swollen belly.
Usually the disease begins gradually, progressing slowly from weeks to months until it leads to fibrosis of the liver and loss of function, if the disease is not identified and treated. However, in some cases, the disease can worsen rapidly, being called fulminant hepatitis, which is extremely serious and can result in death. Know what it is and what are the dangers of fulminant hepatitis.
In addition, in a small proportion of cases, the disease may not cause symptoms, being discovered in routine tests, which show an increase in liver enzymes. It is important that the diagnosis is made early so that the treatment can be soon established by the doctor, being able to avoid complications, such as cirrhosis, ascites and hepatic encephalopathy.
Autoimmune hepatitis in pregnancy
The symptoms of autoimmune hepatitis in pregnancy are the same as those of the disease outside this period and it is important that the woman is accompanied by the obstetrician to check that there are no risks for both her and the baby, which is rare when the disease still finds up at an early stage.
In pregnant women who have the most developed disease and have cirrhosis as a complication, monitoring becomes more important, since there is a greater risk of premature birth, low birth weight and need for cesarean section. Thus, it is important that the obstetrician indicates the best treatment, which is usually done with a corticosteroid, such as Prednisone.
How to confirm
The diagnosis of autoimmune hepatitis is made by assessing the signs and symptoms presented by the person and the result of laboratory tests that must be requested by the doctor. One of the tests that confirms the diagnosis of autoimmune hepatitis is a liver biopsy, in which a fragment of this organ is collected and sent to the laboratory to observe changes in the tissue that indicate autoimmune hepatitis.
In addition, the doctor may order the measurement of liver enzymes, such as TGO, TGP and alkaline phosphatase, in addition to the measurement of immunoglobulins, antibodies and serology for hepatitis A, B and C viruses.
The person's lifestyle habits, such as excessive alcohol consumption and use of drugs that are toxic to the liver, are also taken into account at the time of diagnosis, making it possible to exclude other causes of liver problems.
How the treatment is done
Treatment for autoimmune hepatitis is indicated by the hepatologist or gastroenterologist, and is started with the use of corticosteroid drugs, such as Prednisone, or immunosuppressants, such as Azathioprine, which reduce acute liver inflammation by keeping it under control over the years, and can be done at home. In some cases, especially in young patients, the use of the combination of Prednisone with Azathioprine may be recommended to reduce side effects.
In addition, it is recommended that patients with autoimmune hepatitis eat a varied and balanced diet, avoiding drinking alcohol or eating very fatty foods, such as sausages and snacks.
In the most severe cases, in which it is not possible to control inflammation with the use of medicines, liver transplant surgery, which consists of replacing the diseased liver with a healthy one, can be used. However, as autoimmune hepatitis is related to the immune system and not to the liver, after the transplant it is possible that the disease will develop again.
