Autoimmune hepatitis is uncertain to identify. The accurate cause of autoimmune hepatitis is uncertain. It is multifactorial disorder may be associated with hereditary, environmental, hormonal, and immunological factors. Conversely, the onset of more than half of autoimmune hepatitis has been recognized as "unknown trigger factors".

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Many scientific publications deliberate the probable part of psychological stress, and of the major stress-related hormones, in the pathogenesis of autoimmune disease. It is very difficult to predict the autoimmune hepatitis disorder due to stress.

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Psychological Stress is Associated With Relapse in Type 1 Autoimmune Hepatitis

There are strong evidence stating that psychological stress is a significant factor that is associated with relapse in type 1 autoimmune hepatitis. Type I is more common and tends to affect young women and is associated with other autoimmune diseases. This is the most common variant of autoimmune hepatitis in the United States, Canada, Mexico, and whole of Europe. Stress is also the reason for the incidence of relapse or recrudescence of disease activity in autoimmune hepatitis. Recurrence of autoimmune hepatitis can cause cirrhosis and ultimately liver failure which can be fatal in many individuals.

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Can Autoimmune Hepatitis be Caused by Stress?

It is true that Physical and emotional stressors play a part in the development of autoimmune conditions. This has been proven by various studies conducted on both animals and humans which have shown that immune function of the body gets affected by certain stressors. Furthermore, many retrospective studies also showed that more than 60% of people studied had an emotional or physical stress just before the start of an autoimmune disorder. The theory works both ways meaning that stress promotes development of autoimmune diseases and the disease condition itself is a big stressor to the patient. Recent studies conducted have spoken about the part that psychological stressors play in the development of autoimmune conditions and also the role of the stress hormones in the development of the condition. It has been opined that the neuroendocrine hormones which are believed to cause stress causes immune imbalance ultimately causing an autoimmune disease by increasing the production of cytokine.

Mechanism and Measurement of Stress

Psychological stress activates the hypothalamic-pituitary axis and sympathetic nervous system which causes immune system imbalance and increased production of cytokines. In autoimmune diseases, an increase in the inflammatory response can lead to adverse effects in tissues which are specifically vulnerable to immune stimulation. The stressful life events were measured using Social Readjustment Rating Scale which is the most preferred rating scale used worldwide in research studies.

Treatment of Stress-Induced Autoimmune Hepatitis

The treatment aims at coping with stress and preventing the imbalance hat is caused in the immune system as a result of this stress. Physicians need to discuss various stress reactions with individuals with autoimmune disorders and the patient questionnaire should ask the patient about any physical or psychological stress that he or she might be going through apart from trauma, infection, and other triggers which are commonly seen with autoimmune conditions. Management of autoimmune hepatitis may benefit from strategies to reduce stress and promote psychological well being.

Conclusion

Type 1 autoimmune hepatitis cause a progressive necroinflammatory liver disease because of psychological stress. Stress activates hypothalamic-pituitary axis and sympathetic nervous system causing imbalance of the immune system triggered by increased production of cytokines. Stress is also shown to be one of the primary reasons for recurrence of an autoimmune disorder like autoimmune hepatitis. Thus, measures taken to cope with stress can have a positive impact in the overall treatment of a condition like autoimmune hepatitis and also promote psychological well-being.

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: January 16, 2019

This article does not provide medical advice. See disclaimer

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