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Pediatric autoimmune hepatitis (AIH)
Autoimmune hepatitis (au·to·im·mune hep·a·ti·tis) or AIH occurs when the body’s immune system mistakenly attacks and damages the liver, causing inflammation that can lead to other conditions.
What is autoimmune hepatitis?
Autoimmune hepatitis is a chronic (long-lasting) liver disease that can occur at any age and typically affects more girls than boys. Without treatment, this condition can have lasting impacts, including liver complications and additional autoimmune diseases such as:
Celiac disease
An autoimmune disorder that attacks the small intestine when a child eats gluten
Cirrhosis
A condition that causes the liver to develop scar tissue in place of healthy liver tissue
Inflammatory bowel disease
A gastrointestinal condition that causes ulcerative colitis (sores and swelling in the colon and rectum)
Liver cancer
When cancerous cells grow in the liver due to liver damage
Liver failure
When the liver loses its function.
Primary biliary cholangitis (PBC)
A chronic liver disease caused by slow, continual and permanent damage to the bile ducts (tubes that carry digestive liquid from the liver to small intestine)
Primary sclerosing cholangitis (PSC)
A chronic liver disease caused by the bile ducts narrowing and hardening over time
Rheumatoid arthritis
When the immune system mistakenly attacks the joints, causing pain and inflammation
Thyroid conditions
When the thyroid (regulates hormones for growth and development) is attacked by autoimmune disorders, it can cause conditions like Graves’ disease and Hashimoto’s disease
Type 1 diabetes
When the pancreas is destroyed by an autoimmune response, it can make it difficult for the body to regulate blood sugar with insulin and convert food into energy
Vitiligo
When pigment in the skin is destroyed, causing white patches to appear
What are the different types of autoimmune hepatitis?
There are two types of autoimmune hepatitis:
Type 1
Type 1 this is the most common type of the disease, and can occur at any age and more often in girls than boys (about 4 to 1).
Type 2
Type 2 this is more severe and difficult to control, most often occurring in children.
What are the signs and symptoms of autoimmune hepatitis?
Symptoms of autoimmune hepatitis range from mild to severe, depending on the type.
This may include:
- Constantly feeling tired
- Dark-colored urine
- Jaundice (yellowish color to the skin or eyes)
- Joint pain
- Nausea and vomiting
- Pain in the abdomen, specifically near the liver (upper right area)
- Pale-colored stool
- Poor or no appetite
- Skin rashes or vitiligo
What are the causes of autoimmune hepatitis?
The exact cause of autoimmune hepatitis is unknown. A healthy immune system makes antibodies and lymphocytes (white blood cells) to battle infections. But with an autoimmune condition, something changes the normal response pattern – causing the antibodies to see healthy tissues and organs as dangerous infections.
Possible triggers that can lead to an autoimmune response include:
Genetics
Autoimmune diseases can run in families; researchers are looking into what causes this genetic response and how it’s inherited
Medicines
Antibiotics that are used to treat acne (minocycline) and urinary tract infections (nitrofurantoin) can cause liver damage that resembles autoimmune hepatitis
Viruses
Experts are researching how a body’s initial response to fighting a common virus can lead to a larger autoimmune response
Autoimmune hepatitis doctors and providers
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Lauren Lazar, MD Pediatric Gastroenterologist -
To Nhu Nguyen, PA-C Physician Assistant - Gastroenterology