Autoimmune hepatitis is a progressive inflammatory liver disease, the etiology of which is unknown. This liver disease is characterized by the appearance in the blood of specific antibodies and hypergammaglobulinemia.
When carrying out histological studies of the liver when the disease is detected stage foci of necrosis and borderline hepatitis. Autoimmune hepatitis is a quite dangerous disease, as it progresses rapidly and affects large parts of the liver. And in a short period of time this condition can cause the appearance of portal hypertension, liver cirrhosis and even liver failure without organ transplantation leads to the death of the patient. The exact causes of this condition, such as chronic autoimmune hepatitis is yet to be determined.
Characteristic features of autoimmune hepatitis
Autoimmune liver disease diagnosed primarily in women. According to statistics, 71% of cases this condition is detected in females. Note that autoimmune hepatitis can develop at almost any age. Cases were identified for the development of this liver disease in children at the age of 9 months, as well as the people who turned 77-year-old age limit. Symptoms can manifest themselves in different degrees of intensity in different forms of the disease. In some cases, the symptoms are very acute.
Especially often there is an acute period in patients with concomitant autoimmune diseases, including thyroiditis, ulcerative colitis, synovitis and other features of the condition.
In acute course of this autoimmune liver disease may experience the following symptoms:
- heaviness in the region of the hypochondrium;
- pain in the hypochondrium;
- disorders of defecation;
- constant feeling of fatigue;
- muscle weakness;
- yellowing of the sclera of the eye.
At the same time, the acute course of the disease and is observed only in 15% of cases. In most cases autoimmune hepatitis does not cause pronounced cholestasis, so patients usually do not complain of any symptoms and do not experience skin problems, including itching and do not feel you do not have hyperpigmentation.
Asymptomatic is extremely dangerous, as the disease is already revealed when developing autoimmune cirrhosis of the liver.
Diagnosis of the disease
Currently, autoimmune hepatitis is a diagnosis of exception, as once to suspect his presence, the doctor can only be the case if a person has other serious diseases of the same character development. There are 2 main subtype of hepatitis of this nature. Most adults have 1 like that of hepatitis, and this age group is only 15-17% of the identified comorbidities. Autoimmune hepatitis in children, usually refers to the 2 type, and in 40% of cases it develops on the background of other diseases with autoimmune nature.
Diagnosis of this disease requires conduct such studies as:
- a blood test for specific antibodies;
- a blood test for antigens;
- liver biopsy;
- tests for detection of viral markers;
- Ultrasound of the liver.
In addition, diagnosis involves a careful study of history. One of the most informative methods for detection of hepatitis is the histological examination of the damaged liver tissue through which can be identified is the characteristic speed of the foci of necrosis are rarely observed in other diseases of the liver. During a biopsy can be was diagnosed with autoimmune cirrhosis of the liver.
The preliminary diagnosis requires exclusion of diseases such as Wilson’s disease, primary sclerosing cholangitis, primary biliary cirrhosis, cholangitis, chronic hepatitis C, drug-induced hepatitis, hemochromatosis, deficiency of alpha-antitrypsin, non-alcoholic steatohepatitis.
Treatment of autoimmune hepatitis presents a significant challenge and not in all cases possible to achieve long remission.
In this case, to eliminate inflammation in the tissues of the liver requires mono or combination therapy, including the acceptance of drugs, such as:
- Vitamin complexes.
In most cases, requires the use of combination regimens of drugs, as this reduces the risk of side effects, corticosteroid therapy is a necessary measure, when it has been proved the progression of the disease. A special indication for treatment with corticosteroids is disability and the manifestation of a large number of necrotic foci in the liver. Even at the stage of development of autoimmune cirrhosis of the liver, corticosteroid therapy often allows to achieve remission in some patients. In addition, the patients require special diet in autoimmune hepatitis. It involves a complete rejection of alcohol, fatty and fried foods, and foods that negatively affect the condition of the liver.
Approximately 9% of patients even with all the recommendations is not observed, and continues a steady progression of the disease. In fact, the prognosis for treatment and recovery of liver largely depends on how intensively developing inflammatory lesions. As a rule, in the presence of 10-fold excess aspartataminotranferase and 5-fold excess of the level of AST, often combined with hypergammaglobulinemia, 3-year survival of patients is about 50%.
Patients who have detected a lower biochemical activity, the prognosis is usually favorable, since it is possible to achieve a longer remission. More than 80% of patients observed 15-year survival rate, while the risk of development of cirrhotic changes of the liver is about 50%. Various complications of the disease can dramatically worsen the prognosis of survival of the patient.
To maintain the health of the patients require directed medical therapy in the period of relapse, and diet and maintaining a healthy lifestyle.