Autoimmune hepatitis is a rheumatic liver disease that can be seen at all ages, in both genders and in all ethnic groups. If left untreated, it may progress to advanced liver damage called cirrhosis and lead to death.
Autoimmune hepatitis patients may not have any complaints, but may experience weakness, general illness, upper right abdominal pain, exhaustion, fatigue, weight loss, They may have long-standing complaints such as nausea, itching, jaundice, and joint pain.
Autoimmune hepatitis patients may not show any clinical findings, or they may present with a finding such as severe liver failure. In some patients, advanced liver damage called cirrhosis may have occurred at the time of admission. It should be noted that in some acute-onset autoimmune hepatitis patients, immunoglobulin levels may be normal and antibodies such as ANA and SMA may be negative. It should be known that delayed diagnosis and treatment in such patients may cause advanced liver damage.
Liver biopsy should be performed in the diagnosis of the disease. In addition, antibodies such as ANA, SMA, SLA/LP, LKM-1, LC-1, LKM-3, p-ANCA, Ro52 are used in blood tests to diagnose autoimmune hepatitis patients and determine the subtypes of the disease. These antibodies are initially negative and may become positive in the course of the disease.
If cirrhosis develops in autoimmune hepatitis disease, the risk of liver cancer increases. Therefore, these patients need to be under close control for early diagnosis and treatment of liver cancer. Ultrasound check every 6 months is appropriate for these patients.
Autoimmune hepatitis patients may have other liver diseases. AMA and cholangiography should be planned in patients with cholestatic factors.
It is known that autoimmune hepatitis disease occurs after some viral infections. Autoimmune hepatitis should be kept in mind in cases of prolonged hepatitis following viral infections such as Hepatitis A, EBV, HH-6 and measles.
Autoimmune hepatitis may develop after the use of some medications and herbal supplements.
Patients or Other autoimmune rheumatic diseases are common in first-degree relatives. Autoimmune hepatitis; Hashimoto's disease� It can be found together with diseases such as Graves' disease, vitiligo, rheumatoid arthritis, type-1 diabetes, inflammatory bowel diseases, psoriasis, SLE, celiac disease, mononeuritis, polymyositis, hemolytic anemia and uveitis.
Long-term. Autoimmune hepatitis patients receiving immunosuppressant treatment should be followed up for skin cancers and ultraviolet protection should be planned.
Serum IgG levels in autoimmune hepatitis patients follow a parallel course with disease activity. In order to say that patients are in complete biochemical well-being, serum AST, ALT and IgG levels must be within normal limits. It should not be forgotten that although the mentioned values are normal, disease activity in the liver may still continue.
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