Premium Nahrungsergänzungsmittel | artgerecht

Autoimmune Hepatitis: Causes, Symptoms and Treatment

Autoimmune hepatitis is a chronic liver inflammation in which the immune system mistakenly attacks the body´s own liver tissue. It can occur at any age and typically requires lifelong treatment.

Regular tips about health Regular tips about health

Things worth knowing about "Autoimmune Hepatitis"

Autoimmune hepatitis is a chronic liver inflammation in which the immune system mistakenly attacks the body´s own liver tissue. It can occur at any age and typically requires lifelong treatment.

What is Autoimmune Hepatitis?

Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease in which the body´s immune system mistakenly identifies liver cells (hepatocytes) as foreign and attacks them. This persistent inflammation can, if left untreated, lead to liver cirrhosis (scarring of liver tissue) and ultimately liver failure. The condition can develop at any age but is significantly more common in women than in men.

Causes and Risk Factors

The exact cause of autoimmune hepatitis has not yet been fully established. It is believed that a combination of genetic predisposition and environmental triggers plays a key role in the development of the disease.

Genetic factors: Specific HLA (Human Leukocyte Antigen) gene variants increase susceptibility to the condition.
Infections: Viral infections such as hepatitis A or Epstein-Barr virus may trigger or amplify the autoimmune response.
Medications: In rare cases, certain drugs can induce a drug-related autoimmune hepatitis.
Other autoimmune conditions: People with type 1 diabetes, rheumatoid arthritis, or celiac disease have an elevated risk of also developing autoimmune hepatitis.

Types of Autoimmune Hepatitis

Autoimmune hepatitis is classified into two main types based on the specific autoantibodies detected:

Type 1 (AIH-1): The most common form, characterized by antinuclear antibodies (ANA) and anti-smooth muscle antibodies (SMA). It can occur in all age groups.
Type 2 (AIH-2): Less common and primarily seen in children and adolescents. It is defined by the presence of anti-LKM-1 antibodies (liver-kidney microsomal antibodies).

Symptoms

The symptoms of autoimmune hepatitis are often nonspecific and may develop gradually. The most common complaints include:

Persistent fatigue and general exhaustion
Upper abdominal pain or pressure in the right upper abdomen
Yellowing of the skin and eyes (jaundice)
Dark urine and pale stools
Itching of the skin (pruritus)
Joint pain (arthralgia)
Loss of appetite and unintentional weight loss
In advanced stages: signs of liver cirrhosis such as fluid accumulation in the abdomen (ascites) or confusion (hepatic encephalopathy)

Diagnosis

Diagnosing autoimmune hepatitis requires a combination of clinical evaluation, laboratory tests, and liver biopsy.

Laboratory Tests

Elevated liver enzymes: ALT (alanine aminotransferase) and AST (aspartate aminotransferase)
Elevated immunoglobulins, particularly IgG
Detection of specific autoantibodies (ANA, SMA, anti-LKM-1)

Imaging

Ultrasound, CT, or MRI of the liver can reveal structural changes but cannot confirm the diagnosis of autoimmune hepatitis on their own.

Liver Biopsy

A liver biopsy (tissue sample from the liver) is considered the gold standard in diagnosis. It reveals characteristic patterns of inflammation, such as interface hepatitis, and helps assess the severity of liver damage.

Treatment

The primary goal of treatment is to suppress the immune response and prevent progression to liver cirrhosis. Therapy generally consists of immunosuppressive medication and often needs to be continued for life.

First-Line Therapy

Prednisone / Prednisolone: A corticosteroid that rapidly reduces inflammation. It is usually started at a higher dose and then gradually tapered.
Azathioprine: An immunosuppressant commonly used in combination with prednisolone to reduce the required steroid dose and minimize side effects.

Alternative Therapies

If first-line therapy is not tolerated or does not achieve remission, alternative immunosuppressants such as mycophenolate mofetil, cyclosporine, or tacrolimus may be considered.

Liver Transplantation

In severe cases with advanced liver cirrhosis or acute liver failure, a liver transplantation may become necessary. However, autoimmune hepatitis can recur even after transplantation.

Prognosis and Outlook

With early and consistent treatment, most patients can achieve remission (resolution of active inflammation) and lead a normal life. Regular follow-up appointments are essential to monitor treatment response and detect any relapse at an early stage. Without treatment, the disease typically progresses and can lead to life-threatening complications.

References

European Association for the Study of the Liver (EASL): EASL Clinical Practice Guidelines on Autoimmune Hepatitis. Journal of Hepatology, 2015.
Manns MP, Lohse AW, Vergani D: Autoimmune hepatitis -- Update 2015. Journal of Hepatology, 2015.
Mack CL, Adams D, Assis DN et al.: Diagnosis and Management of Autoimmune Hepatitis in Adults and Children. Hepatology, 2020.

Building Blocks for a Healthy Life

As an integrated manufacturer, we develop & produce evidence-based, patented, and non-patented formulations. We work exclusively with plant and natural extracts according to the strictest purity & quality standards.
The combination of science & modern technology with the laws of nature creates solutions consistently tailored to humans – for the highest good: health.

Most read entries

3 Posts in this encyclopedia category