Autoimmune Hepatitis – Diagnosis and Treatment
Diagnosis
Doctors use a mix of tests to find autoimmune hepatitis. Blood tests check for antibodies unique to autoimmune hepatitis and help tell it apart from other liver diseases, like viral hepatitis.
These tests also help sort out if the patient has type 1 or type 2 autoimmune hepatitis.
Liver function tests measure enzymes and proteins in the blood to check how well the liver works. An ultrasound shows if the liver looks normal or if there are signs of damage.
Doctors often perform a liver biopsy. They take a small piece of the liver with a thin needle and examine it under a microscope to confirm the diagnosis and see how much harm the disease has caused.
Treatment
Doctors focus treatment for autoimmune hepatitis on stopping the immune system from harming the liver. They use medicines to reduce immune activity and prevent further liver damage.
Most people start with a type of corticosteroid that lowers inflammation and calms the immune system. Doctors may prescribe it in high doses at first and then slowly reduce the amount to limit side effects.
Common side effects of long-term corticosteroid use include:
- Diabetes
- Bone thinning or fractures
- Increased blood pressure
- Cataracts and glaucoma
- Weight gain
To help reduce these problems, doctors often add an immunosuppressive drug that helps control the immune system’s activity.
This combination can control the disease with less risk from steroids. Even if symptoms improve, stopping the medicine can cause the disease to return. Some people may need to take these drugs for life to keep the condition under control.
Replacing the Liver with a Donor Organ
If medicines do not work, or if the liver becomes badly scarred (cirrhosis) or fails, surgeons may perform liver replacement surgery. In this procedure, surgeons remove the affected liver and replace it with a healthy one from a donor.
Most donor livers come from people who have died, but sometimes a living person can donate a part of their liver. After the operation, both the recipient’s new liver and the donor’s remaining liver begin to regrow to normal size.
| Treatment Approach | When Used | Main Goal |
|---|---|---|
| Medicines | First choice, ongoing management | Slow or stop immune attack |
| Liver Replacement Surgery | Severe, unresponsive cases or liver failure | Replace damaged liver, restore function |
Getting Ready for Your Visit
Steps You Can Take Before Your Appointment
Being prepared can help make your appointment easier and more productive. Use the list below to organize your information and questions:
Check for any special instructions. Ask the clinic if there are things you need to do before the visit, such as fasting or avoiding certain foods.
Make a list of symptoms. Write down any changes or problems you have noticed, such as tiredness, yellowing of the skin (jaundice), joint pain, or stomach discomfort.
Record important life changes. Note events like high stress or big changes in your daily life, as these may affect your health.
Gather a list of all medications and supplements. Include prescription medicines, over-the-counter products, vitamins, and herbal remedies.
Bring support if possible. Consider asking a family member or friend to go with you for help taking notes or remembering the doctor’s advice.
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Write down your questions. Be ready with questions about your symptoms, possible tests, treatment options, and lifestyle changes. You might want to ask:
What could be causing my fatigue and other symptoms?
Could any of my medicines be affecting my liver?
What tests will I need, like blood work or a liver biopsy?
How serious is my liver problem?
Are there lifestyle or diet changes I should make?
Will I need to see a specialist, like a hepatologist?
What are the risks of each treatment?
How often do I need follow-up visits?
Questions Your Health Provider May Ask
Knowing what your doctor might ask can help you prepare clear answers and save time during your visit. The doctor or nurse will likely ask about:
- When your symptoms first started. Be ready to give dates or a time frame.
- How often and how intense your symptoms are. For example, if you have fatigue or jaundice, note how often you feel tired or if you notice yellowing in the eyes or skin.
- Changes in symptoms. Think about what makes your symptoms better or worse.
- Medications and supplements. Bring a complete list, including anything you take for other health issues.
- Family medical history. Tell your provider about liver diseases or autoimmune conditions in your family.
Bringing information about your symptoms, daily habits, and medication list helps your care team determine the next steps more quickly. Talking openly about symptoms and worries ensures good communication and helps build a plan that works for you.
