**Autoimmune hepatitis is diagnosed based on medical history, physical examination, blood tests, imaging tests and liver biopsy. Blood tests can show signs of autoimmune hepatitis or other liver diseases. The doctor can use a liver biopsy to check the characteristics of autoimmune hepatitis and to check for cirrhosis.** **If this disease is not treated, it may progress and lead to complications such as cirrhosis. If autoimmune hepatitis leads to cirrhosis, a person should have a healthy and balanced diet.** **In this article, we review everything you need to know about autoimmune hepatitis.**

### **What is autoimmune hepatitis?** **The liver is a large organ that is located under the ribs and on the right side of the human abdomen and helps to filter the body's waste materials, makes bile to help digest food, and stores sugar that the body uses for energy.** **Autoimmune hepatitis occurs when the body's infection-fighting system (immune system) attacks a person's liver cells, resulting in swelling, inflammation, and liver damage. Therefore, autoimmune hepatitis is a non-contagious, chronic, inflammatory and autoimmune disease in which the individual's immune system attacks healthy and normal liver cells.** ** The cause of the destruction of liver cells in this disease is unclear, but it may be related to the imbalance in some cells of the immune system. The persistent inflammation in the liver seen in autoimmune hepatitis can lead to scarring that eventually leads to cirrhosis, liver failure requiring a liver transplant, and even death.** **Autoimmune hepatitis is about 4 times more common in women than in men and is usually associated with other autoimmune diseases, including type 1 diabetes, Hashimoto's thyroiditis, and celiac disease. In fact, 25 to 50% of autoimmune hepatitis patients get another autoimmune disease at the same time during their life.**

**Types of autoimmune hepatitis** **There are two types of autoimmune hepatitis: type 1 and type 2.** - **Autoimmune hepatitis type 1, which is also known as the classic type, is usually diagnosed in adulthood.** **Autoimmune hepatitis type 2 is diagnosed in childhood, but both types of autoimmune hepatitis are treated similarly. However, type 2 autoimmune hepatitis can be more severe and difficult to control.** ### **How common is autoimmune hepatitis?** **In general, both men and women can get autoimmune hepatitis, but the probability of getting this disease is 3 to 4 times higher in women than in men. Autoimmune hepatitis can occur at any age, however, it is more commonly diagnosed in women at the age of 45. 30 to 50% of people diagnosed with autoimmune hepatitis have another autoimmune disease, such as thyroid disease, rheumatoid arthritis, ulcerative colitis, or type 1 diabetes.** ### **What causes autoimmune hepatitis?** **Regarding the main cause of autoimmune hepatitis, it is not completely clear, but according to experts, it is most likely in people with other autoimmune diseases, including:** - **thyroiditis** - **Grave's disease** - **type 1 diabetes** - **hemolytic anemia** - **immune thrombocytopenia** - **celiac disease** - **ulcerative colitis** - **In rare cases, some drugs can cause autoimmune hepatitis.** **Therefore, in general, autoimmune hepatitis may be caused by one of three autoimmune factors, environmental triggers, and genetic predisposition.** 1. **Autoimmunity: is a process in which a person's immune system makes antibodies that attack and damage the cells and organs of his body.** 2. **Environmental stimuli: Environmental stimuli means factors outside the body. For example, a virus, the use of certain drugs, or contact with other toxins may cause autoimmune hepatitis.** 3. **Genetics: Some genes may increase the risk of autoimmune hepatitis.**

**Symptoms of autoimmune hepatitis** ** Autoimmune hepatitis can have no symptoms or its symptoms can vary from mild to severe. At the beginning of this disease, it can be normal not to have symptoms, but in some people, when the autoimmune disease is diagnosed, they may not have symptoms, and symptoms will appear in them later** **Symptoms may vary from person to person. Some may even have no symptoms. Common early symptoms can include fatigue, nausea, vomiting, abdominal pain, weight loss, light-colored stools, dark urine, joint pain, skin rashes, and missed periods in women. Some may have a large liver (hepatomegaly) and spleen (splenomegaly).** **In some people, the symptoms of the disease may appear quickly within a few days.** ### **The most common symptoms of autoimmune hepatitis are:** - **Feeling too tired** - **Mild joint or muscle pains, usually these pains are worse in the morning.** - **Loss of appetite (not feeling hungry) and weight loss** - **Excessive hair growth (usually in women)** - **Loose or frequent bowel movements (diarrhea)** - **Absence of menstruation or irregular cycle** - **Feeling sick (nausea)** - **abdominal pain or bloating** - **skin rash** - **itching** **Once symptoms begin to appear, it can often take weeks or months for these symptoms to appear. The symptoms of autoimmune hepatitis are non-specific, that's why the doctor may not immediately attribute the person's symptoms to liver disease.** **More severe symptoms, which usually occur late in the disease, may include:** - **accumulation of fluid in the legs, feet and ankles** - **accumulation of fluid in the abdomen** - **Abnormal blood vessels on the skin** - **Pale or greasy feces** - **anal bleeding or vomiting blood** - **confused** - **Bruise** - **dark urine (juice)** - **jaundice** **If the person is not treated properly, there is a risk of developing the disease in the form of liver fibrosis. Over time, a person may develop cirrhosis of the liver, which can increase the risk of liver failure, fluid build-up in the abdomen (ascites), gastrointestinal bleeding from abnormal blood flow in the esophagus and stomach, confusion associated with poor liver function, and even liver cancer.** **Autoimmune hepatitis detection method** **Because many people have no specific signs or symptoms, and the symptoms of this disease are shared by many other diseases, autoimmune hepatitis is often diagnosed by a medical professional in the early stages, either when the person has had routine tests or when the person has been tested for an unrelated disease.** **In people with symptoms, the diagnosis is usually made by taking a detailed medical history, performing a physical exam, a range of blood tests, and a liver biopsy. Diagnosing autoimmune hepatitis is usually done by observing test results and ruling out other causes of liver disease such as fatty liver disease or viral hepatitis.** Some of the blood tests that are used in the laboratory to diagnose autoimmune hepatitis include: - ** Liver function tests that check inflammation or damage to a person's liver. ** - **Complete blood count or CBC checks the number and types of blood cells of a person.** - **Coagulation panel test, which examines how clotting proteins work.** - **Electrolyte panel that checks whether a person has electrolyte balance or not.** - **Autoimmune antibodies are used to check whether a person has autoimmune hepatitis or another liver disease with similar symptoms.** **Of course, other liver tests may also be performed to check various liver diseases, such as imaging tests.** - ** CT scan during which detailed images are taken of every part of the body, including bones, muscles, fats and organs. Both x-rays and computer technology are used to create horizontal images (often slices) of the body.** - **MRI, this test makes accurate images of the organs and structures inside the person's body. It uses a magnetic field and radio wave energy pulses. A dye may be injected or injected into your vein. This color helps the liver and other abdominal organs to be seen more clearly in the scan.** - **Ultrasound that uses high-frequency sound waves to create an image of the organs. It can also check the blood flow in a person's veins.** **In liver biopsy, small tissue samples are taken from the liver with a needle. These samples are examined under a microscope to determine the type of liver disease.**

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**Treatment of autoimmune hepatitis** **Once autoimmune hepatitis is diagnosed, treatment is almost always required. When autoimmune hepatitis is diagnosed early, treatment has the best results. The goal of treatment is to control the disease and reduce or get rid of symptoms (in recovery). The type of treatment used is called immunosuppression (decreasing the activity of the body's immune system). This method is performed using a combination of drugs.** **To do this, drugs (corticosteroids and immunosuppressants) are used to help reduce or suppress the overactive immune system, which prevents the patient's body from attacking his liver.** **The main goal of treatment is to stop liver inflammation by suppressing the immune system or making it less active, but this can also reduce the immune system's ability to fight infection. Reducing liver inflammation improves a person's symptoms, improves liver function tests, reduces scarring, and helps prevent long-term liver damage and liver failure.** **After the treatment is long-term, it lasts at least two years or usually for the rest of the life. Stopping treatment may be possible in a small number of people with autoimmune hepatitis, but this is not without risk as it may cause the disease to come back and may require further treatment.** **After starting the treatment, it may take 6 months to several years for the disease to recover. Some people can stop taking the drug, but often the disease relapses. You may need treatment from time to time for the rest of your life. Some people, if they have relapsed many times or if their disease is severe, they must remain under treatment.** **In some cases, autoimmune hepatitis may go away without any medication. But for most people, autoimmune hepatitis is a chronic disease and can lead to scarring of the liver (cirrhosis), and in this condition, the liver may be severely damaged so that it is no longer able to perform its functions, this condition is called liver failure. If a person has liver failure, he may need a liver transplant.** **The last word is...** ** AIH or autoimmune hepatitis is an autoimmune disease, which means that environmental, genetic or immune factors somehow make the immune system of a person think that his liver cells are dangerous. This causes cells in the body that normally attack foreign invaders (such as viruses and bacteria) to begin attacking the liver. This leads to inflammation and liver damage.** **Symptoms associated with autoimmune hepatitis include fatigue, itching, jaundice, nausea, vomiting, abdominal pain, weight loss, light stools, dark urine, joint pain, rashes, and irregular menstruation in women. Autoimmune hepatitis is usually diagnosed through examination of the patient's symptoms, blood tests, and liver biopsy.** **Although there is no cure for autoimmune hepatitis, it can often be controlled with medications, including steroids and other agents that suppress the immune system. People with autoimmune hepatitis often need to see a gastroenterologist or liver specialist to manage their condition.** **You can contact us for more information and advice.** Stay in touch with us

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