Is Autoimmune Hepatitis Serious?

Autoimmune hepatitis is a potentially serious and life threatening medical condition since ther5e is no specific test meant for a confirmative diagnosis of this condition. It is rather made by combining the results of the history, imaging, and laboratory tests and ruling out of other probable conditions causing the symptoms like hereditary, cholestatic, viral, metabolic, and other drug-induced conditions. High transaminase and immunoglobulin G (IgG) levels, positive autoantibodies, and interface hepatitis are some of the characterized factors of this chronic inflammatory liver disease. If untreated, it has a poor prognosis. This inflammatory disease of the liver can lead to acute liver failure and end-stage liver disease requiring liver transplantation.

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Is Autoimmune Hepatitis Serious?

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Recurrent Autoimmune Hepatitis

Approximately 30% of people having a liver transplant for autoimmune hepatitis normally have a recurrence. The diagnosis of recurrent autoimmune hepatitis is made by the same parameters that are used for patients who have not undergone a transplant. The primary cause for recurrence of the condition is not yet known. The frequency rate however increases from 10% at 1 year to 40% after 5 years of transplantation with possible progression to cirrhosis.

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Autoimmune Hepatitis Different Forms

Patients may have acute, acute severe (fulminant), or sometimes asymptomatic state of autoimmune hepatitis. Acute presentation of autoimmune hepatitis occurs in about 70% of patients with severe presentation with ultimate development of hepatic encephalopathy within a month of diagnosis is seen in less than 10% of North American and European individuals. Whereas asymptomatic cases are seen in about 30% of patients and the diagnosis should be given a consideration in people with newly diagnosed LFT abnormalities. Symptoms of asymptomatic develop in 26% to 70% of patients within 2 to 120 months (mean interval, 32 months).

Prevalence of Autoimmune Hepatitis

The disease has a universal distribution, can affect any age, either females or males, irrespective of the ethnicity of the affected individual. Based on limited epidemiologic studies, the incidence of type 1 autoimmune hepatitis among Caucasoid populations of Europe and North America ranges from 0.1 to 1.9/100,000/year. Natives from Alaska have a high tendency of presenting with acute icteric disease at its onset. African-Americans tend to have a more progressive form of this disease than native Americans. Hispanics tend to have more advanced form of the disease at its onset with highest cases of cirrhosis. In retrospect, people from Asian decent have very poor prognosis from this disease even though it is rarely found in countries like Japan.

Liver-Related Death

Long-term survival was reduced in patients with autoimmune hepatitis. There are no variations with regard to gender observed relative to the overall prognosis but a study has pointed to increased fatality in young males than females. This may be due to the disease onset being much earlier than females. The poor prognosis is primarily due to cirrhosis which ultimately causes liver failure leading to fatality. However, majority of fatalities were due to hepatocellular carcinoma.

Conclusion

A diagnosis of autoimmune hepatitis is made by combing the results of the history, imaging, and laboratory findings and ruling out other conditions causing the symptoms like hereditary, viral, cholestatic, metabolic, and drug-induced diseases. Long-term survival was reduced in patients with autoimmune hepatitis. Cirrhosis at diagnosis was a risk factor for poor prognosis and the overall risk of liver-related death was increased. This inflammatory disease of the liver can lead to acute liver failure and end-stage liver disease requiring liver transplantation. Approximately 30% of individuals who have liver transplant for autoimmune hepatitis tend to have recurrence with time.

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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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