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Tuesday, May 20, 2014

In the Spotlight: Autoimmune Hepatitis

8:05 AM Posted by Tiffany Taft , ,
Today's blog entry is written by our awesome summer intern, Jessica Naftaly.

Since we love spreading awareness about rare diseases, we decided to post an additional rare diseases blog this month. May is hepatitis awareness month! Many assume that the ONLY way to be diagnosed with hepatitis is through drugs, drinking too much alcohol, or having unprotected sexual intercourse. Additionally, it is sometimes assumed that all types of hepatitis are contagious. All of these assumptions are untrue. One type of hepatitis called autoimmune hepatitis (AIH) occurs when the body attacks the liver causing inflammation.

Snapshot: AIH is a chronic autoimmune liver condition in which healthy liver cells are mistaken for being foreign and are attacked. The body attacking itself leads to cirrhosis or inflammation of the liver. Overtime without treatment AIH can cause the need for a liver transplant due to liver failure. Although the cause of AIH is not researched well, other autoimmune diseases, environmental factors, and genetics may play a role in AIH development. Symptoms include jaundice, dark colored urine, fatigue, itching, joint pain, nausea, skin rashes, pain in the upper right quadrant of the abdomen, and light colored stool. There are two types of AIH, type 1 and type 2.

How Common is it?
About 0.1-1.2 per 100,000 Americans have AIH. AIH is more commonly seen in females. The disease can show up at any age but is usually seen in ages 10-20 years old or 45-70 years old.

What About Diagnosis and Treatment?
Blood tests can detect elevated liver enzymes, which could be an indication of inflammation. A liver biopsy is the gold standard for diagnosis. Although AIH is not contagious, if untreated it can lead to serious problems. Treatments include medications such as prednisone, azathioprine, and other types of immunosuppressants such as cellcept. Liver transplants are used for patients who do not respond to medication or are in liver failure.

What is the Social and Emotional Impact?
There is stigma associated with the word hepatitis. Some patients with AIH do not disclose their illness for fear of being discriminated. Instead of saying “I have AIH” many prefer to say “I have a liver disease.” Patients who take prednisone may face emotional mood swings, swelling in the face, weight gain, and sleep disturbances that can contribute to difficulty adjusting emotionally and socially. Yellowing of the skin/eyes and uncontrollable itching due to jaundice can make social interactions complex taking a toll on patients emotionally. There is limited research on the social and emotional impact on AIH patients. A study from Yale University School of Medicine, however, found that psychological stress correlated with AIH patients who relapsed.

Helpful Resources
American Liver Foundation
National Digestive Diseases Information Clearinghouse