What are some symptoms that indicate that one has Autoimmune Hepatitis?

Answer 1

Definition

An autoimmune liver disease panel is a series of tests performed when autoimmune liver disease is suspected. An autoimmune liver disease means that the body's immune system attacks the liver.

These tests include:

• Anti-liver/kidney microsomal antibodies
• Anti-mitochondrial antibodies
• Anti-nuclear antibodies
• Anti-smooth muscle antibodies

Occasionally, the panel may also include additional tests. Certain immune protein levels in the blood are also checked.

Alternative Names

Liver disease test panel - autoimmune

How the test is performed

Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

The blood sample is sent to the laboratory for testing.

How to prepare for the test

No special preparation is necessary for this test.

How the test will feel

When the needle is inserted to draw blood, some people feel pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed

Autoimmune disorders, in which cells from the immune system attack tissues or organs, are one possible cause of liver disease. The most common autoimmune liver diseases are autoimmune hepatitis and primary biliary cirrhosis.

This group of tests helps your health care provider diagnose liver disease.

Normal Values

Protein levels:

The normal range for protein levels in the blood will change with each laboratory. Please check with your health care provider for the normal ranges in your particular laboratory.

Antibodies:

Negative results on all antibodies are normal.

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What abnormal results mean

Blood tests for autoimmune diseases are not completely accurate. They can have false negative results (you have the disease, but the test is negative) and false positive results (you do not have the disease, but the test is positive).

A "weakly positive" or "low titer positive" test for autoimmune disease is often not due to any disease.

A positive test on the panel may indicate autoimmune hepatitis or other autoimmune liver disease.

If the test is positive mostly for anti-mitochondrial antibodies, there is a high probability of primary biliary cirrhosis.

If the immune proteins are high and albumin is low, you may have liver cirrhosis or chronic active hepatitis.

What the risks are

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

References

Hoofnagle JH. Chronic hepatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 152.

Answer 2

Definition

Autoimmune hepatitis is inflammation of the liver that occurs when immune cells mistake the liver's normal cells for harmful invaders and attack them.

Alternative Names

Lupoid hepatitis

Causes, incidence, and risk factors

This disease is associated with other autoimmune diseases, including:

• Hemolytic anemia
• Proliferative glomerulonephritis
• Thyroiditis
• Type 1 diabetes
• Ulcerative colitis

Autoimmune hepatitis sometimes occurs in relatives of people with autoimmune diseases, which suggests that there is a genetic cause.

This disease is most common in young girls and women.

Symptoms

• Abdominal distention
• Dark urine
• Fatigue
• Generalized itching
• General discomfort, uneasiness, or ill feeling (malaise)
• Loss of appetite
• Nausea and vomiting
• Pale or clay-colored stools

Other symptoms that may occur with this disease include absence of menstruation (amenorrhea).

Signs and tests

• Abnormal liver function tests
• Liver biopsyshowing chronic hepatitis

Tests associated with autoimmune hepatitis:

• ANA
• Anti-liver kidney microsomal antibody
• Anti-mitochondrial antibody
• Sedimentation rate
• Serum IgG

Treatment

Prednisone or other corticosteroid medications help reduce the inflammation. Azathioprine and mercaptopurine are drugs used to treat other autoimmune disorders. They have been shown to help patients with autoimmune hepatitis, as well.

Some patients may receive a liver transplant.

Expectations (prognosis)

The outcome varies. Corticosteroid therapy may slow the disease progression. However, autoimmune hepatitis may worsen to cirrhosis and require a liver transplant.

Complications

• Cirrhosis
• Complications related to steroids and other medications
• Hepatocellular carcinoma
• Liver cell failure

Calling your health care provider

Call your health care provider if you notice symptoms of autoimmune hepatitis.

Prevention

Autoimmune hepatitis is usually not preventable. Awareness of risk factors may allow early detection and treatment.

ReferencesLuxon BA. Diagnosis and treatment of autoimmune hepatitis.Gastroenterology Clinics. June 2008;37.

Answer 3

Definition

Autoimmune hepatitis is inflammation of the liver that occurs when immune cells mistake the liver's normal cells for harmful invaders and attack them.

Alternative Names

Lupoid hepatitis; Chronic acute liver disease

Causes, incidence, and risk factors

In patients who have an autoimmune disease, the immune system can't tell the difference between healthy body tissue and harmful, outside substances. The result is an immune response that destroys normal body tissues.

Liver inflammation, or hepatitis may occur along with other autoimmune diseases, including:

• Graves disease
• Inflammatory bowel disease
• Rheumatoid arthritis
• Scleroderma
• Sjogren syndrome
• Systemic lupus erythematosus
• Thyroiditis
• Type 1 diabetes
• Ulcerative colitis

Autoimmune hepatitis sometimes occurs in relatives of people with autoimmune diseases, which suggests that there is a genetic cause.

This disease is most common in young girls and women.

Symptoms

• Abdominal distention
• Dark urine
• Fatigue
• General discomfort, uneasiness, or ill feeling (malaise)
• Itching
• Loss of appetite
• Nausea or vomiting
• Pale or clay-colored stools

Other symptoms that may occur with this disease include absence of menstruation (amenorrhea).

Signs and tests

• Abnormal liver function tests
• Liver biopsyshowing chronic hepatitis

Tests for autoimmune hepatitis:

• Anti-liver kidney microsome type 1 antibody(anti LKM-1)
• Anti-nuclear antibody (ANA)
• Anti-smooth muscle antibody (SMA)
• Serum IgG

Treatment

Prednisone or other corticosteroid medications help reduce the inflammation. Azathioprine and 6-mercaptopurine are drugs used to treat other autoimmune disorders. They have been shown to help patients with autoimmune hepatitis, as well.

Some patients may receive a liver transplant.

Expectations (prognosis)

The outcome varies. Corticosteroid therapy may slow the disease progression. However, autoimmune hepatitis may worsen to cirrhosis and require a liver transplant.

Complications

• Cirrhosis
• Complications related to steroids and other medications
• Hepatocellular carcinoma
• Liver failure

Calling your health care provider

Call your health care provider if you notice symptoms of autoimmune hepatitis.

Prevention

Autoimmune hepatitis is usually not preventable. Awareness of risk factors may allow early detection and treatment.

References

Czaia AJ. Autoimmune hepatitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 88.

Reviewed By

Review Date: 11/23/2010

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Answer 4

Definition

An autoimmune liver disease panel is a series of tests that is done when a person is thought to have autoimmune liver disease. An autoimmune liver disease means that the body's immune system attacks the liver.

These tests include:

• Anti-liver/kidney microsomal antibodies
• Anti-mitochondrial antibodies
• Anti-nuclear antibodies
• Anti-smooth muscle antibodies

Sometimes the panel may also include other tests. Often immune protein levels in the blood are also checked.

Alternative Names

Liver disease test panel - autoimmune

How the test is performed

A blood sample is needed. For information on how this is done, see: Venipuncture.

The blood sample is sent to the laboratory for testing.

How to prepare for the test

No special preparation is needed for this test.

How the test will feel

When the needle is inserted to draw blood, some people feel pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

Why the test is performed

In autoimmune disorders, cells from the immune system attack tissues or organs. These disorders are one possible cause of liver disease. The most common autoimmune liver diseases are autoimmune hepatitis and primary biliary cirrhosis.

This group of tests helps your health care provider diagnose liver disease.

Normal Values

Protein levels:

The normal range for protein levels in the blood will change with each laboratory. Please check with your health care provider for the normal ranges in your particular laboratory.

Antibodies:

Negative results on all antibodies are normal.

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What abnormal results mean

Blood tests for autoimmune diseases are not completely accurate. They can have false negative results (you have the disease, but the test is negative) and false positive results (you do not have the disease, but the test is positive).

A weakly positive or low titer positive test for autoimmune disease is often not due to any disease.

A positive test on the panel may be a sign of autoimmune hepatitis or other autoimmune liver disease.

If the test is positive mostly for anti-mitochondrial antibodies, you are likely to have primary biliary cirrhosis.

If the immune proteins are high and albumin is low, you may have liver cirrhosis or chronic active hepatitis.

What the risks are

Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

References

Angulo P, Lindor KD. Primary biliary cirrhosis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 89.

Czaia AJ. Autoimmune hepatitis. In: In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 88.

Hoofnagle JH. Chronic hepatitis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 152.

Reviewed By

Review Date: 02/04/2011

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Answer 5

Some symptoms of Autoimmune Hepatitis include joint pain, enlarges liver, skin rashes, fatigue and itching. These may be minor or severe in some cases.