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| | Digestive Health Autoimmune hepatitis | |
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admin Admin
Posts : 2302 Reputation : 0 Join date : 2010-12-20 Age : 46
| Subject: Digestive Health Autoimmune hepatitis Sun Jan 02, 2011 9:01 pm | |
| Autoimmune hepatitis is inflammation in your liver that occurs when your body's immune system attacks your liver. Although the cause of autoimmune hepatitis isn't entirely clear, some diseases, toxins and drugs may trigger autoimmune hepatitis in susceptible people, especially women. 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 when liver disease is advanced. Symptoms Signs and 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, problems in the early stages of the disease, whereas others experience signs and symptoms that may include: * Fatigue * Abdominal discomfort * 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 When to see a doctor Make an appointment with your doctor if you have any signs or symptoms that worry you. Causes 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 an interaction between several risk factors, such as infections, medications and a genetic predisposition. Types of autoimmune hepatitis Doctors have identified two main forms of autoimmune hepatitis: * Type 1 (classic) autoimmune hepatitis. Often developing suddenly, 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's most common in young girls and often occurs with other autoimmune problems. Risk factors Factors that may increase your risk of autoimmune hepatitis include: * Being female. Although both men and women can develop autoimmune hepatitis, the disease is far more common in women. * Age. Type 1 autoimmune hepatitis can occur at any age. Type 2 primarily affects young girls. * A history of certain infections. Autoimmune hepatitis may develop after a bacterial or viral infection. * Use of certain medications. Certain medications, such as the antibiotic minocycline and the cholesterol medication atorvastatin (Lipitor) have been linked to autoimmune hepatitis. * Heredity. Evidence suggests that a predisposition to autoimmune hepatitis may run in families. Complications Diseases that can occur in people with autoimmune hepatitis Autoimmune hepatitis may be associated with a variety of other autoimmune diseases, including: * Pernicious anemia. Associated with a number of autoimmune disorders, pernicious anemia occurs when a lack of vitamin B-12 interferes with your body's ability to form red blood cells. * Hemolytic anemia. In this type of anemia, your immune system attacks and breaks down red blood cells faster than your bone marrow can replace them. * Thrombocytopenic purpura. Platelets are blood cells that help your blood clot. In thrombocytopenic purpura, your immune system attacks and destroys these cells, leading to easy bruising and bleeding. * Ulcerative colitis. This inflammatory bowel disease can cause severe bouts of watery or bloody diarrhea and abdominal pain. * Autoimmune thyroiditis (Hashimoto's thyroiditis). In this condition, the immune system attacks the thyroid gland. * Rheumatoid arthritis. Another autoimmune disease, rheumatoid arthritis occurs when the immune system attacks the lining of your joints, leading to stiffness, pain, swelling, and sometimes deformity and disability. * Celiac disease. This disease causes an abnormal reaction to gluten, a protein found in most grains. Eating gluten sets off an immune response that damages the small intestine. Complications of liver damage Autoimmune hepatitis that goes untreated can cause permanent scarring of the liver tissue (cirrhosis). Complications of cirrhosis include: * Increased blood pressure in the vein that sends blood into the liver. Blood from your intestine, spleen and pancreas enters your liver through a large blood vessel called the portal vein. If scar tissue blocks normal circulation through your liver, this blood backs up, leading to increased pressure within the portal vein (portal hypertension). * 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 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. At this point, a liver transplant is the only option. * Liver cancer. People with cirrhosis have an increased risk of liver cancer. Preparing for your appointment If you have any signs or symptoms that worry you, start by making an appointment with your family doctor. If your doctor suspects you may have a liver problem, such as autoimmune hepatitis, you may be referred to a doctor who specializes in liver diseases (hepatologist). Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be prepared for your appointment. Here's some information to help you get ready, and what to expect from your doctor. What you can do * Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet. * Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment. * Write down key personal information, including any major stresses or recent life changes. * Make a list of all medications, as well as any vitamins or supplements, that you're taking. * Take a family member or friend along. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot. * Write down questions to ask your doctor. Your time with your doctor is limited, so preparing a list of questions will help you make the most of your appointment. List your questions from most important to least important in case time runs out. For autoimmune hepatitis, some basic questions to ask your doctor include: * Do I have autoimmune hepatitis? * Could any of my medications cause my liver problems or make my liver problems worse? * How severe is the damage to my liver? * What kinds of tests do I need? * Is my condition likely temporary or chronic? * What are my treatment options? * Can treatment cure my autoimmune hepatitis? * What are the potential side effects of each treatment option? * I have these other health conditions. How can I best manage them together? * Are there any restrictions that I need to follow? * Should I see a specialist? What will that cost, and will my insurance it? * Is there a generic alternative to the medicine you're prescribing me? * Are there any brochures or other printed material that I can take with me? What Web sites do you recommend? * What will determine whether I should plan for a follow-up visit? In addition to the questions that you've prepared, don't hesitate to ask questions at any time that you don't understand something. Tests and diagnosis Tests and procedures used to diagnose autoimmune hepatitis include: * Blood tests. Testing a sample of your blood for antibodies can distinguish autoimmune hepatitis from viral hepatitis and other disorders with similar symptoms. Antibody tests also help pinpoint the type of autoimmune hepatitis you have. * Liver biopsy. Doctors perform a liver biopsy to confirm the diagnosis and to determine the degree and type of liver damage. During the procedure, a small amount of liver tissue is removed, using a thin needle that's passed into your liver through a small incision in your skin. The sample is then sent to a laboratory for analysis. Treatments and drugs The goal in treating autoimmune hepatitis is to slow or stop your body's immune system from attacking your liver. This may help slow the progress of the disease. Medications to control your immune system (immunosuppressants) Medications used to treat autoimmune hepatitis include: * Prednisone. Doctors usually recommend an initial high dose of the corticosteroid drug prednisone for people with autoimmune hepatitis. As soon as signs and symptoms improve, the medication is reduced to the lowest possible dose that controls the disease. Most people need to continue taking the prednisone for years and some people for life. Although you may experience remission a few years after starting treatment, the disease usually returns when the drug is discontinued. Prednisone, especially when taken long term, can cause a wide range of serious side effects, including diabetes, thinning bones (osteoporosis), broken bones (osteonecrosis), high blood pressure, glaucoma and weight gain. * Azathioprine (Imuran). Azathioprine, another immunosuppressant medication, is sometimes used along with prednisone. Using both medications may reduce the dosage of prednisone needed, reducing its side effects. Side effects of azathioprine may include difficulty fighting infections and nausea. Rare side effects include liver damage, pancreas inflammation (pancreatitis) and cancer. * Other immunosuppressants. If you don't respond to prednisone or azathioprine, your doctor may prescribe stronger immunosuppressants, such as cyclosporine (Sandimmune) or tacrolimus (Prograf). Liver transplant When medications don't halt the progress of the disease, or you have or develop irreversible scarring (cirrhosis) or liver failure, the remaining option is a liver transplant. During a liver transplant, your diseased liver is removed and a healthy liver from a donor is placed in your body. Liver transplants most often use livers from deceased organ donors. In some cases, a living-donor liver transplant can be used. During a living-donor liver transplant, you receive only a portion of a healthy liver from a living donor. | |
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