Autoimmune hepatitis is liver inflammation that occurs when your body's immune system turns against liver cells. The exact cause of autoimmune hepatitis is unclear, but genetic and enviromental factors appear to interact over time in triggering the disease.
Untreated autoimmune hepatitis can lead to scarring of the liver (cirrhosis) and eventually to liver failure. When diagnosed and treated early, however, autoimmune hepatitis often can 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 in cases of advanced liver disease.
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Signs and symptoms of autoimmune hepatitis vary from person to person and may come on suddenly. 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
- Yellowing of the skin and whites of the eyes (jaundice)
- An enlarged liver
- Abnormal blood vessels on the skin (spider angiomas)
- Skin rashes
- Joint pains
- Loss of menstrual periods
When to see a doctor
Make an appointment with your doctor if you have any signs or symptoms that worry you.
Autoimmune hepatitis occurs when the body's immune system, which ordinarily attacks viruses, bacteria and other pathogens, instead targets the liver. This attack on your liver can lead to chronic inflammation and serious damage to liver cells. Just why the body turns against itself is unclear, but researchers think autoimmune hepatitis could be caused by the interaction of genes controlling immune system function and exposure to particular viruses or drugs.
Types of autoimmune hepatitis
Doctors have identified two main forms of autoimmune hepatitis.
- Type 1 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 celiac disease, rheumatoid arthritis or ulcerative colitis.
- Type 2 autoimmune hepatitis. Although adults can develop type 2 autoimmune hepatitis, it's most common in children and young people. Other autoimmune diseases may accompany this type of autoimmune hepatitis.
Factors that may increase your risk of autoimmune hepatitis include:
- Being female. Although both males and females can develop autoimmune hepatitis, the disease is more common in females.
- A history of certain infections. Autoimmune hepatitis may develop after you're infected with the measles, herpes simplex or Epstein-Barr virus. The disease is also linked to hepatitis A, B or C infection.
- Heredity. Evidence suggests that a predisposition to autoimmune hepatitis may run in families.
- Having an autoimmune disease. People who already have an autoimmune disease, such as celiac disease, rheumatoid arthritis or hyperthyroidism (Graves' disease or Hashimoto's thyroiditis), may be more likely to develop autoimmune hepatitis.
Esophageal varices are enlarged veins in the esophagus. They're often due to obstructed blood flow through the portal vein, which carries blood from the intestine, pancreas and spleen to the liver.
Autoimmune hepatitis that goes untreated can cause permanent scarring of the liver tissue (cirrhosis). Complications of cirrhosis include:
- Enlarged veins in your esophagus (esophageal varices). When circulation through the portal vein is blocked, blood may back up into other blood vessels — mainly those in your stomach and esophagus. The blood vessels are thin walled, and because they're filled with more blood than they're meant to carry, they're likely to bleed. Massive bleeding in the esophagus or stomach from these blood vessels is a life-threatening emergency that requires immediate medical care.
- Fluid in your abdomen (ascites). Liver disease can cause large amounts of fluid to accumulate in your abdomen. Ascites can be uncomfortable and may interfere with breathing and is usually a sign of advanced cirrhosis.
- Liver failure. This occurs when extensive damage to liver cells makes it impossible for your liver to function adequately. At this point, a liver transplant is needed.
- Liver cancer. People with cirrhosis have an increased risk of liver cancer.
April 17, 2020
- Overview of chronic hepatitis. Merck Manual Professional Version. https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/hepatitis/overview-of-chronic-hepatitis. Accessed Aug. 27, 2018.
- Elsevier Point of Care. Clinical Overview: Autoimmune hepatitis. https://clinicalkey.com. Accessed Aug. 8, 2018.
- Heneghan MA. Autoimmune hepatitis: Pathogenesis. https://www.uptodate.com/contents/search. Accessed Aug. 6, 2018.
- AskMayoExpert. Autoimmune hepatitis. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
- Autoimmune hepatitis. National Institute for Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/liver-disease/autoimmune-hepatitis/all-content. Accessed Aug. 6, 2018.
- Liver transplantation. Merck Manual Professional Version. https://www.merckmanuals.com/professional/immunology-allergic-disorders/transplantation/liver-transplantation. Accessed Aug. 8, 2018.
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