Have you ever wondered what would happen if the "army" inside our bodies, which is supposed to protect us from disease, sometimes went astray and started attacking our own healthy organs? That's the unfortunate, but actually different thing we're going to talk about today. In this case, our immune system, the defense army, starts attacking our liver for no reason. This is what we call Autoimmune Hepatitis in medicine.
Simply put, what is Autoimmune Hepatitis?
Imagine that there is an army protecting our country. The sole duty of that army is to protect the country from external enemies (i.e. germs like viruses and bacteria). Our body's immune system is like that. It is always on alert, searching for and destroying germs that enter the body.
But, in Autoimmune Hepatitis, something very strange happens. Something goes wrong with this immune system and it recognizes our own liver cells as an "enemy." Then this army, or antibodies, starts attacking our innocent liver cells just as it attacks foreign enemies.
When the liver is continuously attacked in this way, it becomes swollen and inflamed. We call this hepatitis. Over time, this damage can increase and cause serious damage to the liver.
The important thing is that although there is no complete cure for this, with the right treatment, this disease can be very well controlled, preventing damage to the liver and leading a healthy life. It is only if it is left untreated that it becomes dangerous.
This is not a very common disease. Studies have shown that between 10 and 50 people out of every 100,000 develop this disease.
Are there main types of autoimmune hepatitis?
Yes, there are two main types. These two types are distinguished by the type of antibodies that our immune system makes. This is a little complicated, but it's good to know if your doctor talks about it.
| Type | Who is most affected? | Specific antibodies that are relevant |
|---|---|---|
| Type 1 | This is the most common type. It can develop in anyone, but is most common in women under the age of 40. | Anti-smooth muscle antibodies (anti-SMA) and some others. |
| Type 2 | This is very rare, but can be a little more severe than type 1. It is usually diagnosed in early childhood. | Anti-liver-kidney microsomal-1 (anti-LKM-1) antibodies. |
What are the symptoms of this disease?
One thing about this is that not everyone has symptoms. You may not even know you have it. Your doctor may find it by chance when doing a blood test for another condition. For some people, symptoms may appear after the liver function starts to be affected.
If you do develop symptoms, the first thing you may notice is unexplained fatigue. You may feel tired even after sleeping all day.
In addition, you can also see these symptoms:
- Yellowing of the skin and eyes (Jaundice)
- Scratching the skin
- The appearance of various skin rashes
- Joint pain
- Stomach ache
- Nausea and vomiting
- Appetite
- Dark urine (like the color of tea water)
- Pale or gray stools
Why does this kind of disease occur?
Researchers still don't know exactly what causes it. But we do know that it's an autoimmune disease. That means it's caused by something wrong with our immune system. There are several factors that are thought to contribute to it:
- Genetic predisposition: Some people have a genetic predisposition to developing autoimmune diseases. This means that if someone in your family has it, you may also have a slight chance of developing it.
- Viral infections: If you have previously had a viral infection such as Epstein-Barr, herpes, parvovirus B19, or hepatitis A, B, or C, it can "activate" the immune system and cause it to malfunction in this way.
- Environmental factors: Certain toxins or other events in the environment can cause the immune system to become overactive.
- Certain medications: Rarely, certain medications (for example, nitrofurantoin, minocycline, and atorvastatin) can trigger this condition.
Very important: Do not suddenly stop taking any medication you are already taking just because you see this medicine. It can be dangerous. If you have any doubts, talk to your doctor first and follow his or her advice.
Is Autoimmune Hepatitis contagious?
No. Not at all. This is not a contagious disease. Hepatitis types caused by viruses like Hepatitis A, B, and C can be transmitted from one person to another. But Autoimmune Hepatitis is a process that occurs within our body. Therefore, if you touch someone who has this disease, or share food or drink with them, you will not in any way catch this disease.
Who is most at risk of developing this disease?
Studies have shown that this disease is most common among women. Out of 10 patients, 7 are women. Also, this disease most often occurs in the age group between 15 and 40 years.
In addition, someone who already has another autoimmune disease is at higher risk of developing Autoimmune Hepatitis.
| Other Autoimmune Diseases Associated with Autoimmune Hepatitis |
|---|
| Type 1 diabetes |
| Ulcerative colitis (ulcers in the large intestine) |
| Celiac disease (an allergy to gluten) |
| Vitiligo (white patches on the skin) |
| Sjögren's syndrome (a disease that causes dry eyes and mouth) |
| Graves' disease (an overactive thyroid gland) |
| Rheumatoid arthritis |
What are the complications if left untreated?
This is where we all need to focus. If Autoimmune Hepatitis is not treated properly, the damage to the liver can gradually increase and lead to serious complications.
- Cirrhosis: When the liver is damaged over time, healthy liver cells are replaced by scar tissue. The liver becomes hard like a rock. This makes it unable to do its job properly.
- Liver failure: When cirrhosis becomes severe, the liver can stop working completely. This is life-threatening.
- Liver cancer: People with cirrhosis are at increased risk of developing liver cancer.
- Varicose veins: When blood flow through the liver is obstructed, the pressure in the veins in the esophagus and stomach increases and they swell. If these rupture, they can cause severe bleeding.
- Ascites: When the liver is not working properly, fluid begins to accumulate in the abdominal cavity.
How do doctors diagnose this disease?
If you have these symptoms or if a test for another reason shows a problem with your liver, your doctor may suspect this disease. The diagnostic process involves several steps.
1. Asking you for details: The doctor will ask you a lot of questions about your symptoms, whether anyone in your family has this disease, the medications you take, and whether you drink alcohol.
2. Physical examination: Your eyes and skin will be checked for yellowing (jaundice), your abdomen will be checked for swelling of the liver or spleen, fluid in the abdomen, and swollen legs.
3. Specialized tests: Several tests are performed to confirm the disease.
| Test | What do you see in this? |
|---|---|
| Blood tests | Make sure there are no other diseases that affect the liver, such as viral hepatitis. |
| Liver Function Tests | Check your liver enzyme levels. When the liver is damaged, these enzymes accumulate in the blood. |
| Antibody tests | Check the blood for specific antibodies (such as anti-SMA, anti-LKM-1) that attack our own cells. |
| Scans | An ultrasound, CT scan, or MRI scan can check the shape, size, and whether there is any damage to the liver. |
| Liver biopsy (examination of a small piece of the liver) | This is the test that confirms the disease 100% of the time. A very small piece of the liver is taken with a small needle and examined under a microscope. This allows us to know exactly the severity of the disease. |
What are the treatments for this?
The main goal of treatment is to control the overactive immune system and stop damage to the liver. Two main types of drugs are used for this.
1. Corticosteroids
These are steroid medications. They work by quickly reducing inflammation in the body. Your doctor will start you on a high dose and gradually reduce the dose as your condition improves. The most common medication used is prednisone . While this works well for most people, it can cause some side effects. There are other options, such as budesonide , but they are not suitable for people with cirrhosis.
2. Immunosuppressants
As the name suggests, these drugs work by suppressing the immune system, which means slowing it down. They may be started at the same time as steroids, or given after the steroid dose has been reduced. Azathioprine and CellCept® are two of the most commonly used drugs.
Because they have fewer side effects than steroids, they are used as long-term maintenance therapy. You may need to take these medications periodically throughout your life.
How long does it take to see results from treatment?
The ultimate goal of treatment is to achieve remission, which means that all symptoms and test results return to normal. This can take months or even years to achieve.
If the disease has been in remission for at least two years, the doctor may decide to stop the medication. However, after stopping treatment, there is a chance that the disease will come back (relapse). About 50% of people who go into remission will have the disease come back and have to start the medication again.
For some people, the disease does not completely resolve with medication. In such cases, the doctor will try other types of medication. Very rarely, some patients may not respond to treatment at all. If the disease becomes severe or severe complications occur, the last option may be a liver transplant .
What is the future like for someone living with this disease?
This is a problem that many people have. The truth is, if left untreated, this disease is dangerous. If left untreated, about 50% of patients die within 5 years.
But, with the right treatment, the situation is completely different. 91% of those who receive treatment are still alive after 10 years. 70% are still alive after 20 years. That means with treatment, you can live a very successful, long-term life.
Living with a chronic illness like this can be emotionally difficult. But by being aware of your treatment options and working closely with your doctor, you can take control of your health. Informed, committed treatment is the best way to improve your future.
Take-Home Message
- Autoimmune Hepatitis is a disease in which your own immune system attacks your liver. It is not caused by a virus and is not contagious from person to person.
- Unexplained fatigue and jaundice are common symptoms, but some people may not experience any symptoms at all.
- Although there is no complete cure for this, medication can control the disease very well and prevent damage to the liver.
- Treatment is a long-term process. Never stop taking your medication or change the dosage without your doctor's advice.
- With proper and consistent treatment, you can live a long, healthy, and happy life with this disease.
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න