Autoimmune Hepatitis - AIH

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Autoimmune Hepatitis - AIH
Autoimmune Hepatitis - AIH
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Autoimmune hepatitis

In autoimmune hepatitis (AIH), liver cells are attacked by their own immune system. This results in inflammation of the liver (hepatitis). About 17 out of 100,000 residents are affected by AIH. It is therefore responsible for around ten to 20 percent of all chronic liver diseases. Women are about four times more likely to get sick than men - especially during puberty and menopause. Around every second new disease occurs in young people under 30 years of age.

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Causes & Symptoms

The immune system attacks liver cells because it can no longer differentiate between "foreign" and "own". The exact causes are not known, but a hereditary predisposition as well as various triggers such as toxicity, infections or pregnancy are likely to interact. AIH is not contagious.

In rare cases, autoimmune hepatitis can trigger acute liver failure with more or less total failure of liver functions. The first recognizable symptoms are usually jaundice, blood clotting disorders and disorders of consciousness. For the most part, however, AIH ultimately leads to cirrhosis as a chronic disease. Often no symptoms or only unspecific symptoms occur over a long period of time. These include:

  • Fatigue,
  • Lack of appetite,
  • Nausea,
  • Vomit,
  • Reluctance to eat fatty foods and alcohol,
  • diarrhea
  • dizziness
  • Abdominal pain and headache,
  • Fever,
  • light chair,
  • dark urine,
  • Yellowing of the skin / eyes (jaundice)
  • Inflammation of the thyroid gland, blood vessels, large intestine, pleura, skin,
  • Anemia.

diagnosis

If the disease is mild, it is often discovered by chance. The diagnosis is made primarily through laboratory findings. As a sign of impaired liver function, the transaminases (especially GOT, GPT) are usually significantly increased. In these cases, other liver diseases must first be ruled out.

Furthermore, certain autoantibodies (eg ANA, p-ANCA or SMA) can be measured in the blood. But these alone can neither prove nor exclude an AIH. A liver puncture is important because very typical cell changes can often be seen here. The response to immunosuppressive therapy can also provide important information in cases of doubt.

therapy

Usually, immunosuppressants are used - such as glucocorticoids (e.g. predniso (lo) n, budesonide) and azathioprine. Treatment can permanently reduce disease activity. Most often, long-term medication use is necessary to prevent AIH from recurring. If the disease does progress and cirrhosis develops with complications, a liver transplant may be necessary.

forecast

Mild forms of the disease can regress spontaneously, and the prognosis is good even without drug therapy. Most of the patients who respond to the therapy have an almost normal life expectancy. In some people, however, the therapy has no effect and there is an increased risk of liver cirrhosis. You either have the option of being treated as part of studies or of opting for a liver transplant.

Whom can I ask?

Due to the diversity of autoimmune diseases, doctors from various disciplines are responsible for diagnosis and therapy - depending on the body structure affected, e.g. internal medicine, gastroenterology, endocrinology, rheumatology, ophthalmology, etc.

How are the costs going to be covered?

All necessary and appropriate therapies are covered by the health insurance carriers. Basically, your doctor or the outpatient clinic will settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible (BVAEB, SVS, SVS, BVAEB). However, you can also use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic. For more information, see Costs and Deductibles.

If hospitalization is required for treatment, hospital costs will be invoiced. The patient has to pay a daily contribution to the costs. Further medication treatment at home takes place by prescription from the general practitioner, the specialist in dermatology and venereology, or by the specialist in internal medicine.

For more information, see What does a hospital stay cost?

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