Autoimmune liver disease

What is autoimmune disease?

Autoimmune diseases are due to the body mistakenly identifying its own tissues as foreign material. The immune system then attacks these tissues. 

Autoimmune hepatitis (AIH) is due to the immune system targeting the cells of the liver, leading to damage.

The cells of the bile ducts can also be attacked, leading to the conditions primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC).

These conditions are often present for many years before they are diagnosed.

There are various treatments to reduce the symptoms and sometimes stop the condition itself.

At the London Liver Group, we will work with you to understand your condition and provide the very best treatment.

Causes

It is not known exactly what causes autoimmune conditions. It is thought that some people may be more likely to develop them due to an underlying genetic cause. 

This may be coupled with some form of trigger from the environment that causes the immune system to produce antibodies against one of the body’s own tissues.

Autoimmune hepatitis is more common in women than men, and up to 50% of people also have another autoimmune condition. 

AIH causes inflammation and damage to the liver. If untreated it can lead to cirrhosis (scarring) of the liver and liver failure.

PBC is more common in women, whereas PSC is found more often in men.

Both PBC and PSC cause inflammation and scarring of the bile ducts.

Symptoms

When you first develop these conditions, you may not have any symptoms at all. 

Autoimmune hepatitis can cause:
•    Tiredness
•    Joint pains
•    Nausea
•    Itching
•    Loose bowel movements
•    Abdominal pain

Advanced cases of AIH can cause fluid build up in the legs or abdomen, confusion, jaundice, bruising and dark urine.

PBC and PSC can cause:

•    Fatigue
•    Itching
•    Jaundice

Diagnosis

Your specialist will first take a detailed history to understand both your symptoms and the effect that they are having on your life. Your specialist will then examine you, including feeling your abdomen, to look for signs of liver disease.

You will need some blood tests. These will see how well your liver is working and look for evidence of antibodies against the liver or bile ducts. You might have a number of investigations including ultrasound scans, MRI scans, and endoscopy with a dye test to look at the bile ducts.

Your specialist may decide that it is necessary to take a sample of liver tissue with a needle (biopsy). This is usually done under local anaesthetic.  This may show evidence of the condition itself, and also whether there is damage and scarring of the liver.