Autoimmune Hepatitis

Autoimmune hepatitis is a rheumatic liver disease that can be seen in all ages, both sexes and all ethnic groups. If left untreated, it can lead to advanced liver damage called cirrhosis and death.

While patients with autoimmune hepatitis may not have any complaints, they may have complaints such as weakness, general illness, right upper abdominal pain, exhaustion, fatigue, weight loss, nausea, itching, jaundice, and joint pain for many years.

Autoimmune hepatitis patients may not present with any clinical findings, or they may present with a finding such as severe liver failure. In some patients, advanced liver damage called cirrhosis may have occurred at the time of admission. It should be kept in mind that in some acute-onset autoimmune hepatitis patients, immunoglobulin levels may be normal and antibodies such as ANA and SMA may be negative. It should be known that delayed diagnosis and treatment in such patients may cause advanced liver damage.

Liver biopsy should be performed in the diagnosis of the disease. In addition, antibodies such as ANA, SMA, SLA/LP, LKM-1, LC-1, LKM-3, p-ANCA, Ro52 are used in blood tests to diagnose and determine the subtypes of the disease in autoimmune hepatitis patients. These antibodies are negative at the beginning and may be positive in the course of the disease.

If cirrhosis develops in autoimmune hepatitis disease, the risk of liver cancer is increased. Therefore, these patients should be under close control for early diagnosis and treatment of liver cancer. In these patients, an ultrasound control every 6 months is appropriate.

Autoimmune hepatitis patients may be associated with other liver diseases. In patients with cholestatic factors, AMA and cholangiography should be planned.​

Autoimmune hepatitis is known to occur after some viral infections. Autoimmune hepatitis should be kept in mind in cases of prolonged hepatitis after viral infections such as hepatitis A, EBV, HH-6 and measles.​

Autoimmune hepatitis may develop after the use of some drugs and herbal supplements.

Other autoimmune rheumatic diseases are frequently encountered in patients or their first-degree relatives. autoimmune hepatitis; Hashimoto’s disease, graves’ disease, vitiligo, rheumatoid arthritis, type-1 diabetes, inflammatory bowel diseases, psoriasis, SLE, celiac disease, mononeuritis, polymyositis, hemolytic anemia and uveitis can be found together.

Autoimmune hepatitis patients receiving long-term immunosuppressant treatment should be followed up in terms of skin cancers and ultraviolet protection should be planned.​

In autoimmune hepatitis patients, serum IgG levels are parallel to disease activity. Serum AST, ALT and IgG levels should be within normal limits to mean that patients have complete biochemical well-being. Although the mentioned values ​​are normal, it should be noted that disease activity in the liver may still continue.

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