Types of autoimmune hepatitis and prognosis
Autoimmune hepatitis is a chronic liver disease of unknown etiology, the characteristic feature of which is continuous necrosis of liver tissue, accompanied by replacement of normal liver tissue with connective tissue (fibrosis) with subsequent development of liver cirrhosis and progressive liver failure.
There are three types of autoimmune hepatitis:
Type 1 or "classic" is the most common type of autoimmune hepatitis worldwide and accounts for up to 80% of all cases of this disease. People aged 10-20 years and 45-70 years are more often affected by this type of autoimmune hepatitis. In patients with type 1, antinuclear antibodies (ANA) are detected when a person's own immune system for an unknown reason begins to produce special protective proteins - immunoglobulins (antibodies) against antigens of the nucleus and cytoplasm of cells of their own tissues.
In addition to antinuclear antibodies, patients may have antibodies to smooth muscle cells (SMA). In patients with type 1 autoimmune hepatitis, haplotypes DR3, DR4, DR13 of the human leukocyte antigen (HLA) are characteristic.
Up to 10% of all cases of autoimmune hepatitis are type 2.
Type 2 is most often diagnosed in children aged 2-14 years.
The ratio of females to males with type 2 autoimmune hepatitis is 10:1.
Type 2 is characterized by the presence of antibodies to type 1 liver/kidney microsomes (LKM-1) or liver cell cytosol. Human leukocyte antigen (HLA) haplotypes DR3 and DR7 are characteristic of patients with type 2 autoimmune hepatitis.
Also, about 10% of all cases of autoimmune hepatitis are type 3.
Type 3 is characterized by the presence of antibodies to soluble liver antigen/hepatopancreatic antigen (SLA/LP).
Autoimmune hepatitis is diagnosed more often in women. If autoimmune hepatitis is not treated, the 6-month mortality in the presence of this pathology can reach 40%.
However, the 10-year survival rate of patients with autoimmune hepatitis who receive treatment is 80-98%.
Help for patients with diseases of the liver and biliary tract should be provided in specialized centers, and the "Oberig" clinic has at its disposal not only the most modern equipment and technologies, but also a highly professional team headed by Oleg Gennadiyovych Kotenko - a transplant surgeon, doctor of medical sciences, professor, laureate of the State Prize of Ukraine in the field of science and technology (2008). For more than 25 years, Oleg Kotenko has been entrusted with the life and health of patients with complex oncological pathology of the pancreas, liver, and biliary tract.
Symptoms of autoimmune hepatitis
Chronic liver disease, in which there is a continuous death of cells of this organ with replacement by connective tissue, and, as a result, the development of cirrhosis, was named autoimmune hepatitis. The progression of autoimmune hepatitis leads to liver failure, which requires a liver transplant to save the patient's life.
Autoimmune hepatitis is more common in women.
About ⅓ of adults and ½ of children with autoimmune hepatitis have cirrhosis at the time of diagnosis.
The spectrum of clinical signs and symptoms of autoimmune hepatitis can vary widely: from an asymptomatic increase in the level of liver enzymes — alanine aminotransferase (ALT), aspartate aminotransferase (AST) to progressive liver cirrhosis and a fulminant form of liver failure.
Complaints in autoimmune hepatitis are non-specific and are observed in many liver diseases.
They include:
- fatigue;
- lack of appetite — anorexia;
- abdominal pain;
- itching of the skin;
- joint pain - arthralgia.
With an objective examination, the following symptoms help the doctor to suspect the autoimmune nature of this hepatitis:
- inflammation of the joints - arthritis;
- dryness of the mucous membrane of the oral cavity - xerostomia;
- inflammation of the cornea and conjunctiva — keratoconjunctivitis;
- inflammation of skin vessels - vasculitis;
- erythema nodosum;
Patients with an advanced form of autoimmune hepatitis may experience:
- jaundice of the skin and visible mucous membranes;
- an increase in the size of the liver — hepatomegaly and/or spleen — splenomegaly;
- fluid accumulation in the abdominal cavity — ascites;
- pronounced peripheral edema;
In the Pancreatic Surgery and Transplantation Center of the universal clinic "Oberig" (Kyiv) under the leadership of Oleg Gennadiyovych Kotenko (doctor of medical sciences, professor, laureate of the State Prize of Ukraine in the field of science and technology (2008), surgeon, oncologist, transplant doctor) by a highly professional team of doctors, the entire range of diagnostic and therapeutic care is provided to patients with diseases of the pancreas, liver and biliary tract, including donor liver transplantation. Thanks to participation in the pilot project of the Ministry of Health, liver transplantation is performed free of charge for the patient.
To book a consultation, call: 044 521 30 03
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