Materiały źródłowe

• #1 Autoimmune hepatitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/autoimmune-hepatitis/symptoms-causes/syc-20352153

  Symptoms of autoimmune hepatitis vary from person to person and may come on suddenly. Some people have few, if any, recognized problems in the early stages of the disease, whereas others experience symptoms that may include: Fatigue. Belly discomfort. Yellowing of the skin and whites of the eyes, called jaundice. Depending on skin color, this change may be harder or easier to see. An enlarged liver. Irregular blood vessels on the skin, called spider angiomas. Skin rash. Joint pain. Loss of menstrual periods. […] Untreated autoimmune hepatitis can lead to scarring of the liver, called cirrhosis. It can also eventually lead to liver failure. When diagnosed and treated early, however, autoimmune hepatitis often can be controlled with medicines that suppress the immune system. […] Autoimmune hepatitis that goes untreated can cause permanent scarring of the liver tissue, known as cirrhosis.

• #1 Symptoms & Causes of Autoimmune Hepatitis – NIDDK

  https://www.niddk.nih.gov/health-information/liver-disease/autoimmune-hepatitis/symptoms-causes

  People with autoimmune hepatitis may have some of the following symptoms: feeling tired, joint pain, nausea, poor appetite, pain over the liver, in the upper part of the abdomen, yellowish color of the whites of the eyes and skin, called jaundice, darkening of the color of urine, lightening of the color of stools, skin conditions, such as rash, psoriasis, vitiligo, or acne. […] If you have symptoms of autoimmune hepatitis, they can range from mild to severe. […] Many people with autoimmune hepatitis have no symptoms. In such cases, doctors may find you have signs of liver problems during routine blood tests, and this may lead to a diagnosis of autoimmune hepatitis. People without symptoms at diagnosis may develop symptoms later. […] Some people with autoimmune hepatitis don’t have symptoms until they develop complications due to cirrhosis. These symptoms include feeling tired or weak, losing weight without trying, swelling of the abdomen from a buildup of fluid, called ascites, swelling of the lower legs, ankles, or feet, called edema, itchy skin, jaundice, vomiting blood if cirrhosis leads to enlarged veins in the esophagus, called esophageal varices, and those varices burst, confusion or difficulty thinking if cirrhosis leads to a buildup of toxins in the brain, called hepatic encephalopathy.

• #1 Patient education: Autoimmune hepatitis (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/autoimmune-hepatitis-beyond-the-basics

  AUTOIMMUNE HEPATITIS SYMPTOMS […] Many people with autoimmune hepatitis (AIH) have no symptoms. The disorder is often first detected by abnormal laboratory tests performed for an unrelated reason (such as for a life insurance examination). […] When symptoms are present, the most common symptom is fatigue. Some people also have additional symptoms, including jaundice (yellowing of the skin or eyes), itching, skin rashes, joint pain, abdominal discomfort, nausea, vomiting, loss of appetite, dark urine, and pale or gray-colored stools. In its most advanced form, AIH can progress to cirrhosis (severe scarring of the liver). […] Rarely, a person may not know they have AIH until they develop severe liver damage and acute liver failure, which may require urgent liver transplantation. […] LONG-TERM OUTCOME

• #1 Autoimmune Hepatitis: Symptoms & Treatments

  https://liverfoundation.org/liver-diseases/autoimmune-liver-diseases/autoimmune-hepatitis-aih/

  Autoimmune hepatitis is a disease in which the bodys own immune system attacks the liver and causes it to become inflamed. The disease is chronic, meaning it lasts many years. If untreated, it can lead to cirrhosis and liver failure. […] Autoimmune Hepatitis is a serious condition that may worsen over time if not treated. […] Autoimmune Hepatitis can lead to cirrhosis and liver failure. […] Often, the symptoms of autoimmune hepatitis are minor. When symptoms do occur, the most common are fatigue, abdominal discomfort, aching joints, itching, jaundice (yellowing of the skin and whites of the eyes), enlarged liver, nausea and spider angiomas (blood vessels) on the skin. Other symptoms may include dark urine, loss of appetite, pale stools and absence of menstruation. More severe complications can include ascites (fluid in the abdomen) and mental confusion. In 10%-20% of cases, autoimmune hepatitis may present with symptoms like an acute hepatitis.

• #1 Autoimmune Hepatitis: What It Is, Symptoms, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/17867-autoimmune-hepatitis

  Autoimmune hepatitis causes chronic inflammation in your liver, which may cause serious damage over time. Like other types of chronic hepatitis, autoimmune hepatitis can lead to scarring of your liver tissues (cirrhosis). Medical treatment can help reduce the inflammation and prevent complications from developing. However, in the early stages of the disease, you may not have symptoms. […] Not everyone has symptoms with autoimmune hepatitis. Sometimes symptoms develop later, after the disease has begun to affect your liver function. This causes various side effects in your body. […] Some common early symptoms include: Abdominal pain or discomfort. Swollen abdomen with enlarged liver. Fatigue. Joint pain. Skin rashes. Acne. […] When your liver function begins to deteriorate, bile can build up in your bloodstream. This can cause: Jaundice (yellowing of skin and eyes). Dark-colored pee or pale-colored poop. Pruritus (itchy skin). Nausea or loss of appetite.

• #1 Autoimmune Hepatitis | Causes, Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/a/autoimmune-hepatitis

  Autoimmune hepatitis is a condition in which a person’s own immune system attacks the liver, causing swelling and liver cell death. The swelling continues and gets worse over time. If not treated, this can lead to permanent cirrhosis (a disease of the liver caused by liver cells that do not work properly), and eventually liver failure. […] Fatigue (feeling tired all the time) is one of the most common symptoms of autoimmune hepatitis. Other common symptoms include abdominal pain and aching joints. For this reason, often times, autoimmune hepatitis is mistaken for a virus, as the symptoms are similar to that of such an infection. […] When autoimmune hepatitis progresses to severe cirrhosis, there may be jaundice (yellow coloring to the skin and eyes), swelling of the belly caused by fluid, bleeding in the intestines, or mental confusion. Also, females may stop having their menstrual periods.

• #1 Autoimmune Hepatitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459186/

  About 25% of patients with autoimmune hepatitis are asymptomatic. The most common physical findings in autoimmune hepatitis are hepatomegaly (78%) and jaundice (69%) in patients with severe disease. Another common physical finding is splenomegaly with or without cirrhosis. […] The treatment guidelines for autoimmune hepatitis are continually evolving. Untreated individuals develop cirrhosis and subsequently die of liver failure two years from diagnosis. […] Remission occurs when the patient becomes asymptomatic with normalization of inflammatory markers, transaminases, gamma globulin, and histological improvement in liver biopsy. […] Relapse can occur after a patient in remission stops therapy. About 50% of patients have disease relapse within 6 months of discontinuing therapy. […] Liver cirrhosis can develop in about 7% to 40% of treated patients. The development of cirrhosis is associated with incomplete response, treatment failure, and multiple relapses. […] The prognosis for most patients with autoimmune hepatitis is guarded. While survival has improved over the past 2 decades, it still is low. Relapse of the condition is common and some patients may benefit from a liver transplant.

• #1 Autoimmune Hepatitis: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/digestive/liver-diseases/autoimmune-hepatitis

  Autoimmune hepatitis is a chronic inflammation of the liver caused by the bodys own immune system mistakenly attacking healthy liver cells. Left untreated, the condition can lead to impaired liver functioning, cirrhosis of the liver, and even liver failure. […] The signs of autoimmune hepatitis differ from person to person. Initially, you may have no symptoms. Autoimmune hepatitis flare-up symptoms can appear rapidly or develop gradually over time. […] Autoimmune hepatitis symptoms include: Fatigue, Abdominal pain, Nausea and vomiting, Loss of appetite, Jaundice (the yellowing of the skin and the whites of the eyes), Itchy skin, Skin rashes, Joint pain, Spiderlike blood vessels on the skin, Dark-colored urine, Light-colored stools, Loss of menstruation, Enlarged liver. […] Many of these symptoms of autoimmune hepatitis may be caused by cirrhosis (scarring of the liver)a complication of the disease.

• #1 Autoimmune Hepatitis | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/a/autoimmune-hepatitis.html

  Autoimmune hepatitis is when your bodys infection-fighting system (immune system) attacks your liver cells. This causes redness and swelling (inflammation) and liver damage. […] It is a long-term or chronic inflammatory liver disease. […] Each persons symptoms may vary. Some people may have no symptoms or very mild ones, while others can have severe disease and symptoms. Some of the most common symptoms may include: […] Extreme tiredness (fatigue) […] Yellowing of the skin and eyes (jaundice) […] Belly (abdominal) pain […] Joint pain or swelling […] Mild flu-like symptoms […] Itching […] Large abdomen due to large liver and spleen […] Spiderlike blood vessels in the skin. […] Other autoimmune hepatitis symptoms may include: […] Dark urine […] Pale or gray-colored stools

• #1 Autoimmune Hepatitis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/172356-clinical

  Autoimmune hepatitis may present as acute hepatitis, chronic hepatitis, or well-established cirrhosis. Occasionally, it may present as acute liver failure. […] Acute autoimmune hepatitis is common, accounting for 25-75% of new autoimmune hepatitis cases. Patients who present with acute hepatitis may experience fever, hepatic tenderness, and jaundice. In some patients, the acute illness may appear to resolve spontaneously; however, patients invariably develop signs and symptoms of chronic liver disease. A small percentage of patients present with acute severe autoimmune hepatitis, which can progress rapidly to acute liver failure. True acute liver failure (as marked by the new onset of coagulopathy and hepatic encephalopathy) is uncommon. It is seen in 3-6% of new autoimmune hepatitis cases in the United States and Europe.

• #1 Symptoms of autoimmune hepatitis – British Liver Trust

  https://britishlivertrust.org.uk/information-and-support/liver-conditions/autoimmune-hepatitis/symptoms/

  Nearly a quarter of people with autoimmune hepatitis will have no symptoms. […] For some people these can develop quickly over a few days (acute hepatitis). […] Early symptoms can include: An overwhelming sense of tiredness (fatigue), Feeling generally unwell, Itching, Yellowing of the skin and whites of the eyes (jaundice), An aching feeling or discomfort on the upper right side of your tummy (where your liver is), Losing weight for no reason, Joint or muscle pain, Aching joints, Little or no appetite, Feeling sick (nausea), Skin rash, Flu-like symptoms, Missed periods (menstruation). […] If the liver struggles to work more serious symptoms can develop. If you have any of these symptoms, tell a doctor straight away: Yellowing of the skin and whites of the eyes (jaundice), Swelling in the legs, ankles and feet caused by a build-up of fluid (oedema), Swelling in your tummy caused by a build-up of fluid (ascites), Periods of confusion, forgetting things, mood changes or poor judgement (hepatic encephalopathy (HE) or brain fog), A tendency to bleed and bruise more easily, such as frequent nosebleeds and bleeding gums. […] If you have jaundice, you may notice your pee (urine) is darker than usual.

• #1 Acute onset autoimmune hepatitis: Clinical presentation and treatment outcomes | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-acute-onset-autoimmune-hepatitis-clinical-S1665268119300080

  Autoimmune hepatitis (AIH) may present acutely, which can rapidly progress to fulminant type. This pattern has been described worldwide but is generally under-reported. […] Upon initial presentation, 94% had jaundice, 44% had fatigue, 31% had pruritus, and 29% had abdominal pain. […] We confirmed that elevated transaminases are the hallmark of biochemical presentation of acute AIH. High IgG, ANA and ASMA are typically present in such patients upon presentation, however, their absence does not totally exclude the diagnosis. […] The most common symptoms were jaundice (94%) followed by fatigue (44%), itching (31%), and abdominal pain (29%). […] The inflammation was severe (Grade 3) in 70% of the cases and 38.7% had advanced fibrosis upon presentation (Stage 34). […] Fibrosis was highly prevalent in this cohort of patients despite their acute presentation and was associated with poor survival.

• #1 Autoimmune Hepatitis: What It Is, Symptoms, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/17867-autoimmune-hepatitis

  Other late side effects can include: Spider angiomas. Enlarged veins in your esophagus (varices). Easy bruising and bleeding. Loss of menstrual periods. Fluid build-up in your abdomen (ascites) or hands and feet (edema). Confusion, disorientation or drowsiness (hepatic encephalopathy). […] Most people are diagnosed with type 1 AIH in early to middle adulthood, between the ages of 15 and 40. But it can appear at any age. Type 2 AIH typically appears earlier, between the ages of 4 and 14. It may appear with already advanced symptoms of liver disease. […] The goal of the medications is to make the disease go into remission. You may have to take them for several months to years before this happens. Along the way, your healthcare provider will check your liver regularly for signs the treatment is working.

• #1 Patient education: Autoimmune hepatitis (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/autoimmune-hepatitis-beyond-the-basics

  Untreated AIH can cause scarring of the liver and ultimately lead to cirrhosis and liver failure. Fortunately, proper treatment can prevent scarring and cirrhosis in most people. Treatment can be beneficial, even if advanced scarring or cirrhosis has already developed, arresting progression of scarring and, sometimes, reversing the scarring. […] Approximately 10 to 40 percent of people with AIH go into remission and no longer need medications for their condition; however, only approximately 20 to 30 percent of these people stay in remission. Thus, most people need either continuous therapy or additional rounds of medication to treat ongoing disease.

• #1 Autoimmune Hepatitis: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/digestive/liver-diseases/autoimmune-hepatitis

  Left untreated, autoimmune hepatitis can cause severe health complications, including cirrhosis (scarring of the liver tissue). Cirrhosis and its complications can be life-threatening. Rapid onset of liver failure (acute liver failure) can also occur if there is a severe flare of autoimmune hepatitis.

• #1 Autoimmune Hepatitis| Cleveland Clinic

  https://my.clevelandclinic.org/departments/digestive/medical-professionals/hepatology/autoimmune-hepatitis

  Without treatment, approximately 40% to 50% of the individuals with severe disease will die within 6 months to 5 years. Treatment with steroids has dramatically changed the course of the disease. Most patients respond to therapy and the 10-year survival rate is approximately 83.8% to 94%. Thus prompt recognition of the disease and initiation of treatment is critical.

• #1 Autoimmune hepatitis – Wikipedia

  https://en.wikipedia.org/wiki/Autoimmune_hepatitis

  This abnormal immune response results in inflammation of the liver, which can lead to further symptoms and complications such as fatigue and cirrhosis. […] Generally, treatment is not required in asymptomatic patients with normal liver enzyme and antibody levels and liver biopsies that do not demonstrate inflammation because these patients are at a low risk of disease progression. […] Liver cirrhosis can develop in about 7% to 40% of treated patients. People with the highest risk for progression to cirrhosis are those with incomplete response to treatment, treatment failure, and multiple relapses. […] Without treatment, the ten-year survival rate for individuals with symptomatic autoimmune hepatitis is 50%. However, with treatment, the ten-year survival rate is above 90%.

• #1 Autoimmune Hepatitis Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/172356-clinical

  Cirrhosis is seen in 28-33% of adult patients with autoimmune hepatitis at time of presentation and in about 38% of children at time of presentation. Up to 45% of patients have signs of liver decompensation at time of presentation. […] The fact that patients may present with cirrhosis—either well-compensated or decompensated—suggests that patients may be suffering from subclinical autoimmune hepatitis for months or years prior to presentation. […] The chronic hepatitis associated with autoimmune hepatitis may range in severity from a subclinical illness with abnormal liver chemistries and no symptoms to a disabling chronic liver disease. Symptoms and physical examination findings may stem from the various extrahepatic diseases associated with autoimmune hepatitis. Common symptoms include fatigue, upper abdominal discomfort, mild pruritus, anorexia, myalgia, diarrhea, Cushingoid features, arthralgias, skin rashes (including acne), edema, hirsutism, amenorrhea, chest pain from pleuritis, and weight loss and intense pruritus (unusual).

• #1 Autoimmune Hepatitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/172356-overview

  Common findings on physical examination are hepatomegaly (83%), jaundice (69%), splenomegaly (32%), spider angiomata (58%), ascites (20%), and encephalopathy (14%). […] The prognosis of autoimmune hepatitis is excellent for many patients, particularly those who present with minimal or mild liver inflammation and fibrosis. Unfortunately, many patients experience more aggressive disease and have a worse prognosis. […] Factors associated with a worse prognosis include young age at presentation, acute presentation, hyperbilirubinemia, and human leukocyte antigen (HLA) DRB1*03 positivity. […] Patients with type 2 autoimmune hepatitis appear to have a worse prognosis than patients with type 1 autoimmune hepatitis. […] Patients with a severe initial presentation or severe inflammation on liver biopsy tend to have a worse long-term outlook than patients whose initial disease is mild.

• #1 Autoimmune Hepatitis | Choose the Right Test

  https://arupconsult.com/content/autoimmune-hepatitis

  Histology reveals cirrhosis in 28-33% of patients at AIH diagnosis, and these patients, as well as those with bridging necrosis at diagnosis, have a poorer prognosis than those with neither. […] Anti-LC1 autoantibodies are associated with severe liver inflammation and a rapid progression to cirrhosis. […] Anti-SLA/LP autoantibodies are associated with more severe histologic changes, as well as a higher likelihood of relapse, treatment dependence, and transplantation. […] Antiactin autoantibodies are associated with higher likelihoods of treatment dependence, poorer treatment response, and liver failure.

• #1 Autoimmune Hepatitis| Cleveland Clinic

  https://my.clevelandclinic.org/departments/digestive/medical-professionals/hepatology/autoimmune-hepatitis

  The clinical presentation of autoimmune hepatitis varies from asymptomatic to acute liver failure. Symptoms of anorexia, arthralgias, maculopapular rash, and fatigue are typical but not always present. Most patients will have an insidious onset with constitutional symptoms, 25% of patients will be asymptomatic and diagnosed incidentally, and 30% of patients will have acute hepatitis manifestations, the later occurring more often in younger patients. Severe acute hepatitis similar to viral hepatitis can occur. Fulminant hepatic failure is rare and appears to be more common in AIH type 2. […] Autoimmune hepatitis was once a lethal condition with a dismal prognosis. Treatment with corticosteroids has changed the course of the disease and nowadays AIH can be considered a disease with relatively good prognosis in responsive patients.

• #1 Living with AIH | AIHA – Autoimmune Hepatitis Association

  https://aihep.org/living-with-autoimmune-hepatitis/

  Patients with autoimmune hepatitis (AIH) typically lead long lives. With treatment, most patients dont need liver transplants and have normal life expectancies. […] Patients being treated for AIH do well long-term, and most will never need a liver transplant. In a diverse group of patients (including patients of advanced age), 91% are still living after 10 years, and 70% are still living after 20 years without liver transplants. […] When experiencing a flare, some patients may notice the recurrence of symptoms associated with AIH, such as worsening fatigue, itching, joint pain, and gastrointestinal complaints, among others. […] After 10 years of being diagnosed and treated for AIH, about 9 to 10% of patients needed a liver transplant or died from liver-related disease, according to one small study. After 20 years, 30% needed a liver transplant or died from liver-related disease. […] Patients with early fibrosis whose liver enzymes return to normal with treatment will likely live long lives without needing a liver transplant or experiencing liver failure.

• #1 Autoimmune Hepatitis: What It Is, Symptoms, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/17867-autoimmune-hepatitis

  No. It can go into remission. That means the inflammatory process goes away for a time, sometimes for a long time. But after you stop the treatment, it can come back. This is called relapse. Most people (80%) who discontinue their medications will eventually have a relapse and need to start them again. […] Without treatment, life expectancy is 50% within five years. But with treatment, life expectancy is 90% in 10 years and 70% in 20. About 15% of people will eventually develop cirrhosis despite treatment, usually after 10 to 20 years.

• #1

  https://www.nuhs.edu.sg/patient-care/find-a-condition/autoimmune-hepatitis

  Most patients with Autoimmune Hepatitis have no symptoms. […] For the more severe cases of the disease, the most common symptom is fatigue. Some people also have symptoms of Hepatitis such as fever and jaundice (yellowing of the skin or eyes or dark urine). Other symptoms include itching, skin rashes, joint pain, abdominal discomfort, abnormal blood vessels in the skin, nausea and vomiting and loss of appetite. […] In its most advanced form, Autoimmune Hepatitis can progress to cirrhosis (scarring of the liver). […] Approximately 65 and 80 percent of patients achieve remission within 18 months and three years respectively. About 50 percent of patients remain in remission or have only mild disease activity for months to years after treatment is stopped. However, patients whose disease relapses or becomes active again may have to restart treatment. […] A relapse typically occurs within the first 15 to 20 months after treatment is stopped, and is more likely in those who have cirrhosis on the initial liver biopsy.

• #1

  https://link.springer.com/article/10.1007/s10620-022-07484-x

  Significant reduction in quality of life among patients with autoimmune hepatitis (AIH) patients has been observed in several studies. While acute symptoms associated with AIH have been well described, little is known about the overall impact of living with AIH on patients quality of life. […] The participants discussed three overarching topics: (a) symptoms of AIH and medication side effects, (b) the impact the disease and symptoms/side effects on five domains of quality of life (work life, relationships with friends and family, social life, leisure activities, and diet and exercise) and (c) interactions with healthcare providers and recommendations for future research. […] Living with AIH can have profound effects on patients quality of life in several domains. […] Patients with AIH often suffer from extrahepatic effects of the disease or side effects from prescribed therapy, both of which have been reported to reduce overall quality of life.

• #1

  https://link.springer.com/article/10.1007/s10620-022-07484-x

  Depression and anxiety are common in patients with AIH. […] These mental health symptoms are often related to worry regarding liver disease progression and thus possibly amenable to therapy and targeted counselling. […] Because the clinical needs of AIH patients related to a variety of central (e.g., fatigue, depression, anxiety, poor sleep) and peripheral (e.g., joint pain, right upper quadrant pain, itch) symptoms are often unmet, research on the etiology and treatment of these symptoms is critical. […] Participants described a variety of symptoms and medication side effects that affected their quality of life. The symptoms included fatigue, sleep disturbances, neurological symptoms, pain, anxiety, and depression. […] Most participants identified fatigue as a major symptom associated with AIH or its treatment.

• #1

  https://continentalhospitals.com/diseases/autoimmune-hepatitis/

  Autoimmune Hepatitis is a complex liver disease that affects individuals of all ages. The symptoms of Autoimmune Hepatitis can vary from mild to severe and may include fatigue, abdominal discomfort, jaundice (yellowing of the skin and eyes), loss of appetite, and joint pain. If left untreated or undiagnosed, it can lead to serious complications such as cirrhosis (scarring) of the liver or even liver failure. One of the primary symptoms of Autoimmune Hepatitis is fatigue. Patients often experience extreme tiredness, even after getting adequate rest. Another common symptom is jaundice, characterized by yellowing of the skin and eyes. Jaundice occurs due to impaired liver function, leading to a buildup of bilirubin in the body. Abdominal discomfort or pain is also frequently reported by individuals with Autoimmune Hepatitis. This can range from mild discomfort to severe pain and may be accompanied by bloating or tenderness in the abdominal area. Some patients may experience digestive issues such as nausea, vomiting, or loss of appetite. In some cases, joint pain and swelling may occur as a result of an autoimmune response affecting not only the liver but also other parts of the body. It’s worth mentioning that symptoms can vary from person to person, and some individuals may not exhibit any noticeable signs initially. Regular medical check-ups are essential for early detection, especially if there is a family history of autoimmune diseases or liver disorders.

• #1

  https://link.springer.com/article/10.1007/s10620-022-07484-x

  Participants identified sleep disturbances as a highly problematic symptom of AIH. […] Participants described neurological symptoms that they associated with AIH. […] Participants reported experiencing anxiety that they attributed to their AIH. […] Participants also reported depression that they attributed to their AIH. […] Several participants indicated that the side effects from medications used to treat AIH, especially steroids, were highly problematic. […] Participants indicated that AIH affected their work life in several ways. […] Many participants decided to work less or retire since being diagnosed with AIH, primarily because their extreme fatigue made it difficult to manage their responsibilities. […] Participants reported that AIH affected their relationships with family and friends.

• #1 Autoimmune Hepatitis – with Jama Darling, MD | Department of Medicine

  https://www.med.unc.edu/medicine/news/chairs-corner/podcast/autoimmune-hepatitis/

  In regards to fatigue, I think I dont necessarily have a great answer for that one. Our patients that are under a lot of stress and are not sleeping, we try to do things that help with getting a good nights rest, especially if theyre stressed about their condition, encouraging some sort of physical activity improves that.

• #1

  https://link.springer.com/article/10.1007/s10620-022-07484-x

  Participants indicated that AIH affected their social life and experiences being with others in a variety of ways. […] Most participants could not participate in leisure activities they previously enjoyed. […] Many participants reported that they were following a specific or modified diet since being diagnosed with AIH. […] Participants suggested that AIH research should center not only on finding a cure but on management of symptoms that dramatically reduce the quality of their lives. […] Our study confirmed that depression and anxiety can have profound effects on quality of life among patients with AIH. […] Dramatic reduction in quality of life was linked to AIH symptoms and medication side effects as well as lack of a general understanding of the disease, the stigma that accompanies chronic liver disease, and problematic interactions with providers.

• #1 Autoimmune hepatitis treatment options and side effects

  https://www.medicalnewstoday.com/articles/323812

  However, being in remission does not mean that a person is cured of AIH. Without certain treatments, the risk of AIH returning is more than 80%. […] If a person’s AIH progresses and causes liver failure or severe liver scarring, they may require a liver transplant. […] Treatment specific side effects may include: Side effects of prednisone include: bone loss, high blood sugar, increased appetite, insomnia, changes in mood, muscle pain, depression, anxiety. […] Following a liver transplant, a person may experience organ rejection. Organ rejection occurs when a person’s immune system does not recognize the new liver as part of the body. The person’s immune system then attacks the new liver, causing damage. Signs of organ rejection include: fatigue, pain or tenderness in the abdomen, fever, jaundice, dark-colored urine, light-colored stool. […] Complications from AIH include: cirrhosis, which is scarring of the liver, liver failure, acute liver failure, where a person’s liver fails suddenly, liver cancer.

• #1 Autoimmune Hepatitis Symptoms, Diagnosis & Treatment | MedStar Health

  https://www.medstarhealth.org/services/autoimmune-hepatitis

  Autoimmune hepatitis (AIH) is a chronic liver disease that occurs when your bodys natural defense, called the immune system, attacks the liver and causes inflammation for unknown reasons. Over time, liver inflammation can lead to serious damage, including scarring of the liver (cirrhosis) and ultimately, liver failure. […] Symptoms vary by individual and can range from mild to severe. Early in the disease, many people dont experience any symptoms. As it progresses, signs of the disease may include: Fatigue, Joint pain, Yellowing of the skin or eyes (jaundice), Abdominal discomfort or swelling, Itching, Dark urine. […] Its important to seek care if you do experience autoimmune hepatitis symptoms, as early treatment can help prevent damage to the liver and other complications. […] The earlier we can find autoimmune hepatitis, the higher the chance of treatment success. Our goal is to slow down or suppress the immune system so it stops attacking the liver. We can often accomplish this with steroids and other immune suppressant drugs. […] While the condition can be controlled, it currently cannot be cured. As a result, many patients continue taking medication for years to maintain remission. […] If inflammation leads to scarring (cirrhosis) and ultimately, liver failure, liver transplant surgery may be a treatment option.

• #1 Autoimmune Hepatitis | Liver Disease

  https://health.ucdavis.edu/conditions/autoimmune-hepatitis

  You may not have symptoms in the early stages of AIH. If symptoms do occur, they are frequently no specific and include fatigue and weight loss. In some cases, symptoms dont show up until liver damage has occurred. […] Symptoms of AIH are different for everyone. You may experience: Fatigue, Dark urine, Nausea or lack of appetite, Pain in your upper right abdomen, Trouble sleeping. […] AIH can be severe. Seek emergency medical care if you experience: Confusion or trouble thinking, Fluid in your abdomen, Jaundice (yellowing of the eyes or skin), Pale-colored stool, Vomiting blood. […] Treatment usually involves suppressing (calming) the abnormal immune response that causes AIH. The right treatment can relieve symptoms and prevent liver damage. Your liver may also be able to repair itself from previous damage.

• #1 Autoimmune Hepatitis | Causes, Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/a/autoimmune-hepatitis

  The outlook for children with autoimmune hepatitis is generally favorable. In about seven out of 10 people, the disease goes into remission, with symptoms becoming less severe within two years of starting treatment. However, some people whose disease goes into remission will see it return within three years, so treatment may be necessary on and off for years, if not for life.

• #1 GiKids – Autoimmune Hepatitis in Children

  https://gikids.org/digestive-topics/autoimmune-hepatitis-in-children/

  If advanced liver disease develops, symptoms may include: Abnormal blood vessels on the skin (spider angiomas), Yellowing of the skin and whites of the eyes (jaundice), Abdominal swelling, Poor growth, Easy bruising and bleeding, Confusion, loss of alertness, disorientation. […] Children with autoimmune hepatitis generally have an excellent response to treatment. In most cases, however, the disease is controlled but not cured. […] Rarely, the inflammation can lead to severe liver injury in some patients and require a liver transplant.

• #1 What Is Autoimmune Hepatitis? – Hep

  https://www.hepmag.com/basics/liver-health/autoimmune-hepatitis

  Autoimmune hepatitis is a serious condition that may worsen over time if not treated. Autoimmune hepatitis can lead to cirrhosis and liver failure. […] The most common symptoms of autoimmune hepatitis are: fatigue, joint pain, nausea, loss of appetite, pain or discomfort over the liver, skin rashes, dark yellow urine, light-colored stools and jaundice (yellowing of the skin and whites of the eyes). […] Symptoms of autoimmune hepatitis range from mild to severe. Some people may feel as if they have a mild case of the flu. Others may have no symptoms when a health care provider diagnoses the disease; however, they can develop symptoms later. […] Treatment works best when autoimmune hepatitis is diagnosed early. People with autoimmune hepatitis generally respond to standard treatment, and the disease can be controlled in most cases. Long-term response to treatment can stop the disease from getting worse and may even reverse some damage to the liver.

• #2 Autoimmune Hepatitis: Symptoms & Treatments

  https://liverfoundation.org/liver-diseases/autoimmune-liver-diseases/autoimmune-hepatitis-aih/

  Autoimmune hepatitis is a disease in which the bodys own immune system attacks the liver and causes it to become inflamed. The disease is chronic, meaning it lasts many years. If untreated, it can lead to cirrhosis and liver failure. […] Autoimmune Hepatitis is a serious condition that may worsen over time if not treated. […] Autoimmune Hepatitis can lead to cirrhosis and liver failure. […] Often, the symptoms of autoimmune hepatitis are minor. When symptoms do occur, the most common are fatigue, abdominal discomfort, aching joints, itching, jaundice (yellowing of the skin and whites of the eyes), enlarged liver, nausea and spider angiomas (blood vessels) on the skin. Other symptoms may include dark urine, loss of appetite, pale stools and absence of menstruation. More severe complications can include ascites (fluid in the abdomen) and mental confusion. In 10%-20% of cases, autoimmune hepatitis may present with symptoms like an acute hepatitis.

• #2 Autoimmune Hepatitis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459186/

  About 25% of patients with autoimmune hepatitis are asymptomatic. The most common physical findings in autoimmune hepatitis are hepatomegaly (78%) and jaundice (69%) in patients with severe disease. Another common physical finding is splenomegaly with or without cirrhosis. […] The treatment guidelines for autoimmune hepatitis are continually evolving. Untreated individuals develop cirrhosis and subsequently die of liver failure two years from diagnosis. […] Remission occurs when the patient becomes asymptomatic with normalization of inflammatory markers, transaminases, gamma globulin, and histological improvement in liver biopsy. […] Relapse can occur after a patient in remission stops therapy. About 50% of patients have disease relapse within 6 months of discontinuing therapy. […] Liver cirrhosis can develop in about 7% to 40% of treated patients. The development of cirrhosis is associated with incomplete response, treatment failure, and multiple relapses. […] The prognosis for most patients with autoimmune hepatitis is guarded. While survival has improved over the past 2 decades, it still is low. Relapse of the condition is common and some patients may benefit from a liver transplant.

• #2 Autoimmune Hepatitis – Symptoms, Diagnosis, Treatments, Causes

  https://liver.org.au/your-liver/liver-diseases/autoimmune-hepatitis/

  Autoimmune hepatitis is a rare long-term (chronic) disease that can gradually get worse over time. […] It happens when the body’s own immune system damages the liver. This causes inflammation (hepatitis) and injury in the liver. […] If it’s not treated, the inflammation can lead to scarring, then onto cirrhosis and liver failure. […] People with autoimmune hepatitis might not have any symptoms. If there are symptoms, they might be similar to the symptoms of other types of hepatitis, or the flu. Rarely, the first sign of autoimmune hepatitis is when liver suddenly stops working normally (liver failure). […] Signs you might have autoimmune hepatitis include: Feeling very tired (fatigue), Itching, Yellow skin or whites of the eyes (jaundice), Nausea or vomiting, Belly ache, Mild flu-like symptoms, Weight loss, Light coloured poos, Dark urine, Joint pain, Rashes, Periods stop, Large liver or spleen, Spider veins on the skin.

• #2 Symptoms of autoimmune hepatitis – British Liver Trust

  https://britishlivertrust.org.uk/information-and-support/liver-conditions/autoimmune-hepatitis/symptoms/

  Nearly a quarter of people with autoimmune hepatitis will have no symptoms. […] For some people these can develop quickly over a few days (acute hepatitis). […] Early symptoms can include: An overwhelming sense of tiredness (fatigue), Feeling generally unwell, Itching, Yellowing of the skin and whites of the eyes (jaundice), An aching feeling or discomfort on the upper right side of your tummy (where your liver is), Losing weight for no reason, Joint or muscle pain, Aching joints, Little or no appetite, Feeling sick (nausea), Skin rash, Flu-like symptoms, Missed periods (menstruation). […] If the liver struggles to work more serious symptoms can develop. If you have any of these symptoms, tell a doctor straight away: Yellowing of the skin and whites of the eyes (jaundice), Swelling in the legs, ankles and feet caused by a build-up of fluid (oedema), Swelling in your tummy caused by a build-up of fluid (ascites), Periods of confusion, forgetting things, mood changes or poor judgement (hepatic encephalopathy (HE) or brain fog), A tendency to bleed and bruise more easily, such as frequent nosebleeds and bleeding gums. […] If you have jaundice, you may notice your pee (urine) is darker than usual.

• #2 Autoimmune hepatitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/autoimmune-hepatitis/symptoms-causes/syc-20352153

  Symptoms of autoimmune hepatitis vary from person to person and may come on suddenly. Some people have few, if any, recognized problems in the early stages of the disease, whereas others experience symptoms that may include: Fatigue. Belly discomfort. Yellowing of the skin and whites of the eyes, called jaundice. Depending on skin color, this change may be harder or easier to see. An enlarged liver. Irregular blood vessels on the skin, called spider angiomas. Skin rash. Joint pain. Loss of menstrual periods. […] Untreated autoimmune hepatitis can lead to scarring of the liver, called cirrhosis. It can also eventually lead to liver failure. When diagnosed and treated early, however, autoimmune hepatitis often can be controlled with medicines that suppress the immune system. […] Autoimmune hepatitis that goes untreated can cause permanent scarring of the liver tissue, known as cirrhosis.

• #2 Autoimmune hepatitis – UF Health

  https://ufhealth.org/conditions-and-treatments/autoimmune-hepatitis

  Most patients have no symptoms at all. The most common early symptoms include feeling more tired than usual, feeling generally unwell and also joint and muscle pains which are usually worse in the mornings. Jaundice (eyes become yellow) can develop when the liver inflammation becomes worse. This is due to a build-up of the chemical bilirubin which is made in the liver and spills into the blood in some liver conditions. Without treatment, in time the persistent inflammation causes liver damage and can lead to cirrhosis or scarring of the liver. […] Other symptoms can include: Itching, Loss of appetite, Nausea or vomiting, Pale or clay-colored stools, Dark urine, Abdominal distention, Absence of menstruation (amenorrhea) may also be a symptom. […] Treatment works well in most cases. Usually, the inflammation settles and symptoms improve within a few months of starting treatment. However, it may take a year or more to get the disease totally under control. Azathioprine is usually taken for at least three years.

• #2 Autoimmune Hepatitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/172356-overview

  Common findings on physical examination are hepatomegaly (83%), jaundice (69%), splenomegaly (32%), spider angiomata (58%), ascites (20%), and encephalopathy (14%). […] The prognosis of autoimmune hepatitis is excellent for many patients, particularly those who present with minimal or mild liver inflammation and fibrosis. Unfortunately, many patients experience more aggressive disease and have a worse prognosis. […] Factors associated with a worse prognosis include young age at presentation, acute presentation, hyperbilirubinemia, and human leukocyte antigen (HLA) DRB1*03 positivity. […] Patients with type 2 autoimmune hepatitis appear to have a worse prognosis than patients with type 1 autoimmune hepatitis. […] Patients with a severe initial presentation or severe inflammation on liver biopsy tend to have a worse long-term outlook than patients whose initial disease is mild.

• #2 Autoimmune Hepatitis: What It Is, Symptoms, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/17867-autoimmune-hepatitis

  Autoimmune hepatitis causes chronic inflammation in your liver, which may cause serious damage over time. Like other types of chronic hepatitis, autoimmune hepatitis can lead to scarring of your liver tissues (cirrhosis). Medical treatment can help reduce the inflammation and prevent complications from developing. However, in the early stages of the disease, you may not have symptoms. […] Not everyone has symptoms with autoimmune hepatitis. Sometimes symptoms develop later, after the disease has begun to affect your liver function. This causes various side effects in your body. […] Some common early symptoms include: Abdominal pain or discomfort. Swollen abdomen with enlarged liver. Fatigue. Joint pain. Skin rashes. Acne. […] When your liver function begins to deteriorate, bile can build up in your bloodstream. This can cause: Jaundice (yellowing of skin and eyes). Dark-colored pee or pale-colored poop. Pruritus (itchy skin). Nausea or loss of appetite.

• #2 Autoimmune Hepatitis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/autoimmune-hepatitis

  Symptoms of autoimmune hepatitis can include: fatigue, joint pain, nausea or vomiting, jaundice (yellowing of the skin and eyes), urine becoming darker, stool becoming lighter, skin irritation. […] More advanced symptoms of AIH during cirrhosis can look like: fatigue and weakness, unexplained weight loss, ascites (abdominal bloating due to buildup of fluid), edema (swelling in limbs or feet), jaundice, itchy skin. […] Over time, AIH creates scarring in the liver and can lead to liver failure.

• #2 Autoimmune Hepatitis | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/a/autoimmune-hepatitis.html

  Stop in menstrual periods in women […] Loss of appetite […] Fluid buildup in the belly (ascites) […] Confusion […] Rectal bleeding or vomiting blood. […] The symptoms of autoimmune hepatitis may look like other health problems. Always see your healthcare provider for a diagnosis. […] Treatment works best when autoimmune hepatitis is found early. The goal of treatment is to control the disease and to reduce or get rid of any symptoms (be in remission). […] It can lead to scarring of the liver (cirrhosis). The liver can become so badly damaged that it no longer works. This is called liver failure. […] Autoimmune hepatitis is when your body’s infection-fighting system (immune system) attacks your liver cells. […] It is a long-term chronic liver disease that causes redness and swelling (inflammation) and liver damage. […] It can lead to scarring of the liver (cirrhosis) and liver failure.

• #2 Autoimmune Hepatitis: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/digestive/liver-diseases/autoimmune-hepatitis

  Autoimmune hepatitis is a chronic inflammation of the liver caused by the bodys own immune system mistakenly attacking healthy liver cells. Left untreated, the condition can lead to impaired liver functioning, cirrhosis of the liver, and even liver failure. […] The signs of autoimmune hepatitis differ from person to person. Initially, you may have no symptoms. Autoimmune hepatitis flare-up symptoms can appear rapidly or develop gradually over time. […] Autoimmune hepatitis symptoms include: Fatigue, Abdominal pain, Nausea and vomiting, Loss of appetite, Jaundice (the yellowing of the skin and the whites of the eyes), Itchy skin, Skin rashes, Joint pain, Spiderlike blood vessels on the skin, Dark-colored urine, Light-colored stools, Loss of menstruation, Enlarged liver. […] Many of these symptoms of autoimmune hepatitis may be caused by cirrhosis (scarring of the liver)a complication of the disease.

• #2 Acute onset autoimmune hepatitis: Clinical presentation and treatment outcomes | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-acute-onset-autoimmune-hepatitis-clinical-S1665268119300080

  Autoimmune hepatitis (AIH) may present acutely, which can rapidly progress to fulminant type. This pattern has been described worldwide but is generally under-reported. […] Upon initial presentation, 94% had jaundice, 44% had fatigue, 31% had pruritus, and 29% had abdominal pain. […] We confirmed that elevated transaminases are the hallmark of biochemical presentation of acute AIH. High IgG, ANA and ASMA are typically present in such patients upon presentation, however, their absence does not totally exclude the diagnosis. […] The most common symptoms were jaundice (94%) followed by fatigue (44%), itching (31%), and abdominal pain (29%). […] The inflammation was severe (Grade 3) in 70% of the cases and 38.7% had advanced fibrosis upon presentation (Stage 34). […] Fibrosis was highly prevalent in this cohort of patients despite their acute presentation and was associated with poor survival.

• #2 Autoimmune Hepatitis: Symptoms and Treatment

  https://patient.info/digestive-health/hepatitis/autoimmune-hepatitis

  Without treatment, in time the persistent inflammation causes liver damage and can lead to cirrhosis. Cirrhosis is like a scarring of the liver, which can cause serious problems and liver failure when it is severe. […] In some cases, the symptoms develop quickly over a few days with an acute hepatitis. (Acute means sudden in onset or of short duration.) This can cause a fairly sudden onset of: High temperature (fever). Tummy (abdominal) pain. Jaundice. Feeling sick. Being sick (vomiting). Feeling unwell. […] If left untreated, the time it takes from the onset of the condition until severe cirrhosis develops varies from person to person. However, with treatment, the inflammation can usually be controlled and the outlook (prognosis) is good.

• #2 Autoimmune Hepatitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/172356-overview

  Acute severe autoimmune hepatitis is defined as autoimmune hepatitis of less than 26 weeks of duration, in which patients experience jaundice and coagulopathy but do not have evidence of hepatic encephalopathy. Its precise incidence is not well established. Some cases of acute severe autoimmune hepatitis will progress to acute liver failure, which is characterized by the new onset of coagulopathy and hepatic encephalopathy.

• #2 Autoimmune Hepatitis | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/autoimmune-hepatitis

  Autoimmune hepatitis symptoms can come on suddenly or may develop over time. Some children with autoimmune hepatitis do not show any obvious symptoms; such children may only be diagnosed because of abnormal blood test results. When symptoms do appear, they may include: […] Autoimmune hepatitis is a serious, long-lasting (chronic) disease. Right now, there is no cure for autoimmune hepatitis. Fortunately, most children with autoimmune hepatitis respond well to treatment. […] Autoimmune hepatitis can cause scar tissue to start forming on the damaged liver (fibrosis). This makes it harder for the liver to work properly. Over time, lots of scar tissue can build up in the liver (cirrhosis). This can block the blood flowing through the liver and may lead to problems such as bleeding in the esophagus (food pipe) or stomach, or water in the belly (ascites). Cirrhosis also can cause the liver to fail; signs may be jaundice (yellow eyes and skin), bleeding/bruising, or confusion.

• #2 Autoimmune Hepatitis: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/digestive/liver-diseases/autoimmune-hepatitis

  Left untreated, autoimmune hepatitis can cause severe health complications, including cirrhosis (scarring of the liver tissue). Cirrhosis and its complications can be life-threatening. Rapid onset of liver failure (acute liver failure) can also occur if there is a severe flare of autoimmune hepatitis.

• #2 Autoimmune hepatitis (AIH) – British Liver Trust

  https://britishlivertrust.org.uk/information-and-support/liver-conditions/autoimmune-hepatitis/

  Early symptoms can include an overwhelming sense of tiredness (fatigue), feeling generally unwell, itching, and yellowing of the skin and eyes. […] If left untreated it can lead to serious scarring of the liver (cirrhosis). This can then lead to liver cancer or liver failure. […] There are often no signs that you have autoimmune hepatitis and symptoms can be vague.

• #2 Autoimmune Hepatitis: What It Is, Symptoms, and Treatments

  https://www.verywellhealth.com/autoimmune-hepatitis-5195512

  It is possible to go into remission from autoimmune hepatitis. Once your blood tests have reached normal levels, your medical team will work with you to develop a management plan. It is possible for some individuals to discontinue their steroid medication. However, most people require lifelong treatment. […] If steroid therapy is not effective for you, it is possible for autoimmune hepatitis to progress to cirrhosis. This could mean that you will need a liver transplant at some point. About 4% of liver transplants in the United States and Europe are used to treat autoimmune hepatitis. […] For individuals who respond positively to steroid treatment, the 10-year survival rate is 83.8%94%. Without any treatment, 40%50% of individuals with severe autoimmune hepatitis will die within six months to five years.

• #2 Autoimmune Hepatitis – with Jama Darling, MD | Department of Medicine

  https://www.med.unc.edu/medicine/news/chairs-corner/podcast/autoimmune-hepatitis/

  The majority of the patients that we see have liver enzyme elevations but they can have a little bit of nausea, they can have a little bit of discomfort in their right upper abdomen, they can have a lot of fatigue which they didnt realize was associated with autoimmune hepatitis. […] A lot of patients take a number of years to be diagnosed because it does spontaneously remit in some patients. Hence, up to a third of patients at the time of diagnosis will actually have cirrhosis of the liver or bad scarring in the liver, as if this process has been going on for quite some time. […] If you present to the hospital with liver dysfunction and actually have fulminant liver failure, the patients do need to be referred promptly to a liver center. […] Yes, if you present to the hospital with liver dysfunction and actually have fulminant liver failure, the patients do need to be referred promptly to a liver center. Also, if its not clearly obvious, the etiology of the underlying cause for liver enzyme dysfunction, these patients we would like to see sooner rather than later.

• #2 Back to Basics: ANA-lyzing Autoimmune Hepatitis | AASLD

  https://www.aasld.org/liver-fellow-network/core-series/back-basics/back-basics-ana-lyzing-autoimmune-hepatitis

  Autoimmune hepatitis (AIH) is a chronic, progressive immune-mediated inflammatory liver disease. […] Patients with AIH present with a variety of clinical manifestations ranging from asymptomatic to acute liver failure to cirrhosis. An estimated 28-33% of adults with AIH have cirrhosis at presentation. […] Though many patients with AIH have no symptoms, some may experience nonspecific symptoms including fatigue, nausea, and abdominal pain. […] The physical exam is usually unrevealing apart from stigmata of advanced liver disease if the patient has an acute, severe presentation which can lead to jaundice, or cirrhosis (which can also lead to jaundice, positive fluid wave for ascites, cutaneous changes e.g. spider nevi or palmar erythema, splenomegaly, caput medusa). […] The mainstay of the management of AIH is regulating the dysfunctional immune system with immunosuppressive agents.

• #2 Acute onset autoimmune hepatitis: Clinical presentation and treatment outcomes | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-acute-onset-autoimmune-hepatitis-clinical-S1665268119300080

  Elevated transaminases and IgG with positive ANA and ASMA are the hallmarks of acute onset AIH, however, the absence of these parameters does not totally exclude a positive diagnosis. A large proportion of our patients displayed considerable fibrosis and cirrhosis despite the acute presentation. Overall, we observed an excellent initial response to treatment; however, the long-term mortality was higher than the general patient population, particularly for patients with cirrhosis.

• #2 Autoimmune Hepatitis | Choose the Right Test

  https://arupconsult.com/content/autoimmune-hepatitis

  Histology reveals cirrhosis in 28-33% of patients at AIH diagnosis, and these patients, as well as those with bridging necrosis at diagnosis, have a poorer prognosis than those with neither. […] Anti-LC1 autoantibodies are associated with severe liver inflammation and a rapid progression to cirrhosis. […] Anti-SLA/LP autoantibodies are associated with more severe histologic changes, as well as a higher likelihood of relapse, treatment dependence, and transplantation. […] Antiactin autoantibodies are associated with higher likelihoods of treatment dependence, poorer treatment response, and liver failure.

• #2 Celiac Disease and Autoimmune Hepatitis | BeyondCeliac.org

  https://www.beyondceliac.org/celiac-disease/related-conditions/autoimmune-hepatitis/

  Autoimmune hepatitis (AIH) is a condition in which a person’s immune system attacks their liver cells. This autoimmune reaction can cause inflammation, liver damage, and, in some cases, cirrhosis of the liver (scarring that cannot be healed). The cause of this chronic disease is unknown, but AIH occurs most often in people who have other autoimmune disorders. […] Symptoms of autoimmune hepatitis include: Fatigue, Abdominal pain, Joint pain, Jaundice (yellowing of the skin and whites of the eyes), Irregular menstruation or loss of menstruation, Spider angiomas, or collections of blood vessels on the skin that resemble root or web structures, Itching, Dark urine. […] Note that some people have very few or very mild symptoms, while others may have severe and varied symptoms. […] There are two types of AIH: Type 1 is more common and can affect people of all ages, whereas Type 2 autoimmune hepatitis primarily affects children and adolescents. AIH can affect people of all ages and races, although it tends to affect women more commonly than men.

• #2 Autoimmune Hepatitis| Cleveland Clinic

  https://my.clevelandclinic.org/departments/digestive/medical-professionals/hepatology/autoimmune-hepatitis

  Without treatment, approximately 40% to 50% of the individuals with severe disease will die within 6 months to 5 years. Treatment with steroids has dramatically changed the course of the disease. Most patients respond to therapy and the 10-year survival rate is approximately 83.8% to 94%. Thus prompt recognition of the disease and initiation of treatment is critical.

• #2 Autoimmune hepatitis – Wikipedia

  https://en.wikipedia.org/wiki/Autoimmune_hepatitis

  This abnormal immune response results in inflammation of the liver, which can lead to further symptoms and complications such as fatigue and cirrhosis. […] Generally, treatment is not required in asymptomatic patients with normal liver enzyme and antibody levels and liver biopsies that do not demonstrate inflammation because these patients are at a low risk of disease progression. […] Liver cirrhosis can develop in about 7% to 40% of treated patients. People with the highest risk for progression to cirrhosis are those with incomplete response to treatment, treatment failure, and multiple relapses. […] Without treatment, the ten-year survival rate for individuals with symptomatic autoimmune hepatitis is 50%. However, with treatment, the ten-year survival rate is above 90%.

• #2 Autoimmune Hepatitis: What It Is, Symptoms, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/17867-autoimmune-hepatitis

  No. It can go into remission. That means the inflammatory process goes away for a time, sometimes for a long time. But after you stop the treatment, it can come back. This is called relapse. Most people (80%) who discontinue their medications will eventually have a relapse and need to start them again. […] Without treatment, life expectancy is 50% within five years. But with treatment, life expectancy is 90% in 10 years and 70% in 20. About 15% of people will eventually develop cirrhosis despite treatment, usually after 10 to 20 years.

• #2 Living with AIH | AIHA – Autoimmune Hepatitis Association

  https://aihep.org/living-with-autoimmune-hepatitis/

  Patients with autoimmune hepatitis (AIH) typically lead long lives. With treatment, most patients dont need liver transplants and have normal life expectancies. […] Patients being treated for AIH do well long-term, and most will never need a liver transplant. In a diverse group of patients (including patients of advanced age), 91% are still living after 10 years, and 70% are still living after 20 years without liver transplants. […] When experiencing a flare, some patients may notice the recurrence of symptoms associated with AIH, such as worsening fatigue, itching, joint pain, and gastrointestinal complaints, among others. […] After 10 years of being diagnosed and treated for AIH, about 9 to 10% of patients needed a liver transplant or died from liver-related disease, according to one small study. After 20 years, 30% needed a liver transplant or died from liver-related disease. […] Patients with early fibrosis whose liver enzymes return to normal with treatment will likely live long lives without needing a liver transplant or experiencing liver failure.

• #2 Autoimmune hepatitis treatment options and side effects

  https://www.medicalnewstoday.com/articles/323812

  Autoimmune hepatitis (AIH) is a type of liver disease. There are various treatments available for a person who has autoimmune hepatitis. […] Some people with AIH do not have any symptoms. However, possible symptoms of AIH can include: fatigue, joint pain, nausea, diarrhea, poor appetite, loss of brain function, fluid in the abdomen, swollen legs, easy bruising or bleeding, enlarged spleen, gallstones, vomiting, no menstrual period in females, pain in the upper part of the abdomen, jaundice, which causes yellowing of the skin and eyes, dark-colored urine, light-colored stool, skin conditions such as rash, psoriasis, acne, or vitiligo. […] There is no cure for AIH. However, treatments for AIH can help relieve symptoms. They may also prevent or reverse liver damage. […] After receiving treatment for AIH, some people may go into remission. Remission means that a person: no longer has AIH symptoms, has a liver with improved function, is no longer experiencing liver damage.

• #2 Patient education: Autoimmune hepatitis (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/autoimmune-hepatitis-beyond-the-basics/print

  Untreated AIH can cause scarring of the liver and ultimately lead to cirrhosis and liver failure. Fortunately, proper treatment can prevent scarring and cirrhosis in most people. Treatment can be beneficial, even if advanced scarring or cirrhosis has already developed, arresting progression of scarring and, sometimes, reversing the scarring. […] Approximately 10 to 40 percent of people with AIH go into remission and no longer need medications for their condition; however, only approximately 20 to 30 percent of these people stay in remission. Thus, most people need either continuous therapy or additional rounds of medication to treat ongoing disease.

• #2 Autoimmune hepatitis treatment options and side effects

  https://www.medicalnewstoday.com/articles/323812

  However, being in remission does not mean that a person is cured of AIH. Without certain treatments, the risk of AIH returning is more than 80%. […] If a person’s AIH progresses and causes liver failure or severe liver scarring, they may require a liver transplant. […] Treatment specific side effects may include: Side effects of prednisone include: bone loss, high blood sugar, increased appetite, insomnia, changes in mood, muscle pain, depression, anxiety. […] Following a liver transplant, a person may experience organ rejection. Organ rejection occurs when a person’s immune system does not recognize the new liver as part of the body. The person’s immune system then attacks the new liver, causing damage. Signs of organ rejection include: fatigue, pain or tenderness in the abdomen, fever, jaundice, dark-colored urine, light-colored stool. […] Complications from AIH include: cirrhosis, which is scarring of the liver, liver failure, acute liver failure, where a person’s liver fails suddenly, liver cancer.

• #2

  https://www.nuhs.edu.sg/patient-care/find-a-condition/autoimmune-hepatitis

  Most patients with Autoimmune Hepatitis have no symptoms. […] For the more severe cases of the disease, the most common symptom is fatigue. Some people also have symptoms of Hepatitis such as fever and jaundice (yellowing of the skin or eyes or dark urine). Other symptoms include itching, skin rashes, joint pain, abdominal discomfort, abnormal blood vessels in the skin, nausea and vomiting and loss of appetite. […] In its most advanced form, Autoimmune Hepatitis can progress to cirrhosis (scarring of the liver). […] Approximately 65 and 80 percent of patients achieve remission within 18 months and three years respectively. About 50 percent of patients remain in remission or have only mild disease activity for months to years after treatment is stopped. However, patients whose disease relapses or becomes active again may have to restart treatment. […] A relapse typically occurs within the first 15 to 20 months after treatment is stopped, and is more likely in those who have cirrhosis on the initial liver biopsy.

• #2

  https://link.springer.com/article/10.1007/s10620-022-07484-x

  Depression and anxiety are common in patients with AIH. […] These mental health symptoms are often related to worry regarding liver disease progression and thus possibly amenable to therapy and targeted counselling. […] Because the clinical needs of AIH patients related to a variety of central (e.g., fatigue, depression, anxiety, poor sleep) and peripheral (e.g., joint pain, right upper quadrant pain, itch) symptoms are often unmet, research on the etiology and treatment of these symptoms is critical. […] Participants described a variety of symptoms and medication side effects that affected their quality of life. The symptoms included fatigue, sleep disturbances, neurological symptoms, pain, anxiety, and depression. […] Most participants identified fatigue as a major symptom associated with AIH or its treatment.

• #2

  https://link.springer.com/article/10.1007/s10620-022-07484-x

  Participants identified sleep disturbances as a highly problematic symptom of AIH. […] Participants described neurological symptoms that they associated with AIH. […] Participants reported experiencing anxiety that they attributed to their AIH. […] Participants also reported depression that they attributed to their AIH. […] Several participants indicated that the side effects from medications used to treat AIH, especially steroids, were highly problematic. […] Participants indicated that AIH affected their work life in several ways. […] Many participants decided to work less or retire since being diagnosed with AIH, primarily because their extreme fatigue made it difficult to manage their responsibilities. […] Participants reported that AIH affected their relationships with family and friends.

• #2

  https://link.springer.com/article/10.1007/s10620-022-07484-x

  Participants indicated that AIH affected their social life and experiences being with others in a variety of ways. […] Most participants could not participate in leisure activities they previously enjoyed. […] Many participants reported that they were following a specific or modified diet since being diagnosed with AIH. […] Participants suggested that AIH research should center not only on finding a cure but on management of symptoms that dramatically reduce the quality of their lives. […] Our study confirmed that depression and anxiety can have profound effects on quality of life among patients with AIH. […] Dramatic reduction in quality of life was linked to AIH symptoms and medication side effects as well as lack of a general understanding of the disease, the stigma that accompanies chronic liver disease, and problematic interactions with providers.

• #2 What Is Autoimmune Hepatitis? – Hep

  https://www.hepmag.com/basics/liver-health/autoimmune-hepatitis

  Autoimmune hepatitis is a serious condition that may worsen over time if not treated. Autoimmune hepatitis can lead to cirrhosis and liver failure. […] The most common symptoms of autoimmune hepatitis are: fatigue, joint pain, nausea, loss of appetite, pain or discomfort over the liver, skin rashes, dark yellow urine, light-colored stools and jaundice (yellowing of the skin and whites of the eyes). […] Symptoms of autoimmune hepatitis range from mild to severe. Some people may feel as if they have a mild case of the flu. Others may have no symptoms when a health care provider diagnoses the disease; however, they can develop symptoms later. […] Treatment works best when autoimmune hepatitis is diagnosed early. People with autoimmune hepatitis generally respond to standard treatment, and the disease can be controlled in most cases. Long-term response to treatment can stop the disease from getting worse and may even reverse some damage to the liver.

• #2 Autoimmune Hepatitis | Liver Disease

  https://health.ucdavis.edu/conditions/autoimmune-hepatitis

  Our team often begins AIH treatment with corticosteroids. These medications calm inflammation in the liver and prevent further damage. We monitor you for side effects at every step of treatment. […] With the right treatment, most people with AIH never need a liver transplant. But if your liver damage is severe or medications dont work for you, a transplant may be an option.

• #2 Autoimmune Hepatitis | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/autoimmune-hepatitis

  Symptoms of autoimmune hepatitis can vary. Some children have few or no symptoms while others develop symptoms early in the course of the disease. […] Symptoms may include: Fatigue, Lost appetite, Nausea, Pain in the upper abdomen, Jaundice, Dark-colored urine, Light-colored stools, Generally feeling unwell for no clear reason. […] Autoimmune hepatitis is a chronic condition. However, the condition can be managed and responds well to treatment. Early treatment can reverse liver damage caused by autoimmune hepatitis. […] Your child may go into remission after a period of treatment. This is when there are no symptoms or liver damage. If this happens, your child’s doctor may decide to stop the medication but will continue to test your child’s blood to watch for signs of relapse. […] Autoimmune hepatitis is a lifelong condition. It is important for your child to see their doctor on a regular schedule to keep the condition under control.

• #2 Autoimmune Hepatitis Symptoms, Diagnosis & Treatment | MedStar Health

  https://www.medstarhealth.org/services/autoimmune-hepatitis

  Autoimmune hepatitis (AIH) is a chronic liver disease that occurs when your bodys natural defense, called the immune system, attacks the liver and causes inflammation for unknown reasons. Over time, liver inflammation can lead to serious damage, including scarring of the liver (cirrhosis) and ultimately, liver failure. […] Symptoms vary by individual and can range from mild to severe. Early in the disease, many people dont experience any symptoms. As it progresses, signs of the disease may include: Fatigue, Joint pain, Yellowing of the skin or eyes (jaundice), Abdominal discomfort or swelling, Itching, Dark urine. […] Its important to seek care if you do experience autoimmune hepatitis symptoms, as early treatment can help prevent damage to the liver and other complications. […] The earlier we can find autoimmune hepatitis, the higher the chance of treatment success. Our goal is to slow down or suppress the immune system so it stops attacking the liver. We can often accomplish this with steroids and other immune suppressant drugs. […] While the condition can be controlled, it currently cannot be cured. As a result, many patients continue taking medication for years to maintain remission. […] If inflammation leads to scarring (cirrhosis) and ultimately, liver failure, liver transplant surgery may be a treatment option.

• #3 Symptoms of autoimmune hepatitis – British Liver Trust

  https://britishlivertrust.org.uk/information-and-support/liver-conditions/autoimmune-hepatitis/symptoms/

  Nearly a quarter of people with autoimmune hepatitis will have no symptoms. […] For some people these can develop quickly over a few days (acute hepatitis). […] Early symptoms can include: An overwhelming sense of tiredness (fatigue), Feeling generally unwell, Itching, Yellowing of the skin and whites of the eyes (jaundice), An aching feeling or discomfort on the upper right side of your tummy (where your liver is), Losing weight for no reason, Joint or muscle pain, Aching joints, Little or no appetite, Feeling sick (nausea), Skin rash, Flu-like symptoms, Missed periods (menstruation). […] If the liver struggles to work more serious symptoms can develop. If you have any of these symptoms, tell a doctor straight away: Yellowing of the skin and whites of the eyes (jaundice), Swelling in the legs, ankles and feet caused by a build-up of fluid (oedema), Swelling in your tummy caused by a build-up of fluid (ascites), Periods of confusion, forgetting things, mood changes or poor judgement (hepatic encephalopathy (HE) or brain fog), A tendency to bleed and bruise more easily, such as frequent nosebleeds and bleeding gums. […] If you have jaundice, you may notice your pee (urine) is darker than usual.

• #3 Autoimmune Hepatitis: What It Is, Symptoms, Stages & Treatment

  https://my.clevelandclinic.org/health/diseases/17867-autoimmune-hepatitis

  Autoimmune hepatitis causes chronic inflammation in your liver, which may cause serious damage over time. Like other types of chronic hepatitis, autoimmune hepatitis can lead to scarring of your liver tissues (cirrhosis). Medical treatment can help reduce the inflammation and prevent complications from developing. However, in the early stages of the disease, you may not have symptoms. […] Not everyone has symptoms with autoimmune hepatitis. Sometimes symptoms develop later, after the disease has begun to affect your liver function. This causes various side effects in your body. […] Some common early symptoms include: Abdominal pain or discomfort. Swollen abdomen with enlarged liver. Fatigue. Joint pain. Skin rashes. Acne. […] When your liver function begins to deteriorate, bile can build up in your bloodstream. This can cause: Jaundice (yellowing of skin and eyes). Dark-colored pee or pale-colored poop. Pruritus (itchy skin). Nausea or loss of appetite.

• #3

• #3 Autoimmune Hepatitis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/172356-overview

  Common findings on physical examination are hepatomegaly (83%), jaundice (69%), splenomegaly (32%), spider angiomata (58%), ascites (20%), and encephalopathy (14%). […] The prognosis of autoimmune hepatitis is excellent for many patients, particularly those who present with minimal or mild liver inflammation and fibrosis. Unfortunately, many patients experience more aggressive disease and have a worse prognosis. […] Factors associated with a worse prognosis include young age at presentation, acute presentation, hyperbilirubinemia, and human leukocyte antigen (HLA) DRB1*03 positivity. […] Patients with type 2 autoimmune hepatitis appear to have a worse prognosis than patients with type 1 autoimmune hepatitis. […] Patients with a severe initial presentation or severe inflammation on liver biopsy tend to have a worse long-term outlook than patients whose initial disease is mild.

• #3

  https://link.springer.com/article/10.1007/s10620-022-07484-x

  Participants indicated that AIH affected their social life and experiences being with others in a variety of ways. […] Most participants could not participate in leisure activities they previously enjoyed. […] Many participants reported that they were following a specific or modified diet since being diagnosed with AIH. […] Participants suggested that AIH research should center not only on finding a cure but on management of symptoms that dramatically reduce the quality of their lives. […] Our study confirmed that depression and anxiety can have profound effects on quality of life among patients with AIH. […] Dramatic reduction in quality of life was linked to AIH symptoms and medication side effects as well as lack of a general understanding of the disease, the stigma that accompanies chronic liver disease, and problematic interactions with providers.

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