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The immune system's job is to fight and kill things that the body sees as foreign, such as bacteria and viruses. Sometimes, for an unknown reason, the immune system mistakes a part of the body as foreign and starts to attack it. This is called an autoimmune disease.
Autoimmune hepatitis (AIH) is when the immune system attacks the liver. The liver cells become damaged and inflamed (hepatitis). It is a chronic (long-term) disease that can last for years. It can lead to cirrhosis (hardening and scarring) of the liver,
which can get worse over time.
There are medications that can treat AIH, but there is no cure. The earlier it is diagnosed and treated, the more effective the treatment. AIH used to be called lupoid hepatitis.
There are two main types of AIH: type 1 and type 2.
AIH symptoms resemble those of other forms of hepatitis, and sometimes are mistaken for the flu. Symptoms of AIH include:
If your child has any symptoms of AIH, take them to the GP. Your child will be referred to a paediatric gastroenterologist (liver specialist).
To diagnose AIH, blood tests are done to look at how the liver and the immune system are working. A liver biopsy (small sample of the liver taken with a fine needle) is often performed during a general anaesthetic (where your child is put to sleep) and examined under a
microscope. It may take some time for AIH to be diagnosed as several other diseases have the same signs and symptoms as AIH, such as viral hepatitis.
Treatment is based on trying to slow down the immune system. There are two main types of medications that are used to do this:
There are several other medications that can be used and your child's gastroenterologist will discuss these with you. A small number of children can get severe liver disease, and they may need a liver transplant.
Your child's gastroenterologist will also talk to you about any side effects of the medications. Prednisolone has several possible side effects that need to be monitored, including:
Azathioprine also has some side effects including:
Ongoing follow-up with a gastroenterologist will be needed for several years, and your child will need regular blood tests to check their liver function.
There is no known cause for AIH. Many autoimmune diseases seem to be triggered by a viral infection or certain medications.
What are the chances my child will need a liver transplant?
This depends on how far advanced the disease is at diagnosis and the response to treatment. Overall the chances of needing a liver transplant in children with autoimmune hepatitis is very low.
Is there any special diet that can improve my child's
Unfortunately, as diet is not involved in causing the disease or making it worse, only a healthy diet is recommended. There is no evidence to support a “liver cleansing” diet.
Developed by The Royal Children's Hospital Gastroenterology department. We acknowledge the input of RCH consumers and carers.
Reviewed August 2018.
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