Autoimmune hepatitis is inflammation of the liver which occurs when the body's immune system attacks the liver. The cause of autoimmune hepatitis is not clear, but it may appear as a result of some diseases, toxins and drugs affecting women in particular.

If untreated, autoimmune hepatitis can scar the liver (cirrhosis) which may eventually cause liver failure. When diagnosed and treated early, however, autoimmune hepatitis can often be controlled with drugs that suppress the immune system. A liver transplant may be an option when autoimmune hepatitis doesn't respond to drug treatments or when liver disease has progressed.

Two main forms of autoimmune hepatitis have been identified:

  • Type 1 (classic) autoimmune hepatitis. This is the most common type of the disease. It can occur at any age. About half the people with type 1 autoimmune hepatitis have other autoimmune disorders, such as thyroiditis, rheumatoid arthritis or ulcerative colitis.
  • Type 2 autoimmune hepatitis. Although adults can develop type 2 autoimmune hepatitis, it most commonly occurs in young girls, often with other autoimmune problems.

Symptoms

The symptoms of autoimmune hepatitis can range from minor to severe and may come on suddenly or develop over time. Some people have few, if any, recognized problems in the early stages of the disease, whereas others experience signs and symptoms that may include:

  • Abdominal discomfort,
  • Fatigue,
  • Joint pain,
  • Itching (pruritus),
  • Yellowing of the skin and whites of the eyes (jaundice),
  • An enlarged liver,
  • Abnormal blood vessels on the skin (spider angiomas),
  • Nausea and vomiting,
  • Loss of appetite,
  • Skin rashes,
  • Dark-colored urine,
  • In women, loss of menstruation.

Causes

Autoimmune hepatitis occurs when the body's immune system, instead of attacking viruses, bacteria and other pathogens, attacks the liver. This attack can lead to chronic inflammation and serious damage to liver cells. It is unclear why the body turns against itself, it is believed that autoimmune hepatitis could be caused by an interaction between several risk factors, such as infections, medications and a genetic predisposition.

Risk Factors

Factors that may increase the risk of autoimmune hepatitis include:

  • A history of certain infections.
  • Being female. The disease is far more common in women.
  • Age. Type 1 autoimmune hepatitis can occur at any age. Type 2 primarily affects young girls.
  • Use of certain medications. Certain medications  antibiotic minocycline and the cholesterol medication atorvastatin (Lipitor), have been linked to autoimmune hepatitis.
  • Heredity. A predisposition to autoimmune hepatitis may run in families.
  • Having an autoimmune disease.

Complications

Autoimmune hepatitis may be associated with a variety of other autoimmune diseases, including:

  • Pernicious anemia.
  • Hemolytic anemia.
  • Ulcerative colitis.
  • Autoimmune thyroiditis (Hashimoto's thyroiditis).
  • Rheumatoid arthritis.
  • Celiac disease.

Prevention

Cirrhosis is scarring of the liver, and it increases the risk of hepatitis and liver cancer. The risk of cirrhosis can be reduced by:

  • Using  caution with chemicals.
  • Drinking alcohol in moderation, if at all.
  • Maintaining a healthy weight.