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Facts About Autoimmune Hepatitis

By Dr. Pallavi Garg in Gastroenterology, Hepatology & Endoscopy

Jul 24 , 2023 | 2 min read

Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease that occurs when the body's immune system mistakenly attacks liver cells, leading to inflammation and damage. A timely and accurate diagnosis of AIH is crucial to initiate appropriate treatment and prevent further liver damage. The diagnostic process for AIH typically involves a combination of clinical evaluation, laboratory tests, imaging studies, and liver biopsy.

Autoimmune Hepatitis Diagnosis

The diagnosis of AIH begins with medical history and physical examination by a doctor. The doctor will inquire about symptoms such as fatigue, jaundice, and abdominal pain and review any past medical history or family history of liver diseases. A thorough history of other autoimmune conditions like diabetesthyroid disordersrheumatoid arthritis, etc. It is found more commonly in females. Blood tests are essential to evaluate liver function and screen for specific markers associated with AIH.

Imaging studies like ultrasound, or Magnetic Resonance Imaging (MRI), computed tomography (CT) may be performed to assess the liver's structure and rule out other causes of liver disease. While these imaging techniques can provide valuable information, they are not specific to AIH and mainly serve to exclude other conditions.

Liver biopsy remains the gold standard for confirming the diagnosis of AIH. It involves the removal of a small sample of liver tissue for microscopic examination. The biopsy helps evaluate the severity of liver inflammation, fibrosis (scarring), and the presence of characteristic histological features consistent with AIH. The biopsy can also exclude other liver diseases with similar clinical presentations.

Once the diagnosis of AIH is established, it is important to classify the disease as type 1 or type 2 AIH, as this affects treatment strategies and prognosis. 

Autoimmune Hepatitis Treatment

The treatment of autoimmune hepatitis (AIH) aims to suppress the immune system's abnormal response and reduce liver inflammation, thereby preventing further liver damage and promoting long-term remission. The primary treatment for AIH involves the use of immunosuppressive medications, typically corticosteroids and other immunosuppressants.

Regular monitoring of liver function tests and immunosuppressive drug levels is essential during AIH treatment. Adjustments to medication dosages may be necessary based on individual response and disease activity. In some cases, liver transplantation may be necessary if there is advanced liver damage or failure.

Lifestyle modifications are also important in managing AIH. These may include maintaining a healthy diet, avoiding alcohol and certain medications that can potentially harm the liver, and getting vaccinated against hepatitis A and hepatitis B to prevent additional liver injury.

It is crucial for individuals with AIH to have regular follow-up appointments with their healthcare providers to monitor disease progression and treatment response and manage any potential side effects. With appropriate treatment and adherence to medication, many individuals with AIH can achieve remission and lead relatively normal lives.

The diagnosis of autoimmune hepatitis involves a comprehensive approach that includes a careful evaluation of symptoms, laboratory tests to assess liver function and autoimmune markers, imaging studies to rule out other liver diseases, and, ultimately, a liver biopsy for confirmation and classification. Early detection and treatment of AIH are crucial to prevent liver damage and improve long-term outcomes. Therefore, individuals experiencing persistent symptoms or abnormal liver function tests should seek medical attention for proper evaluation and diagnosis.