Hepatitis: Autoimmune Hepatitis

Autoimmune hepatitis is inflammation caused by the body’s immune system attacking the liver. Left untreated, this condition can lead to cirrhosis (scarring of the liver) and even liver failure. 

Key Facts

  • The exact causes of autoimmune hepatitis are still unknown. However, it is likely caused by a combination of environmental and genetic factors.
  • Symptoms can range from mild, such as fatigue and joint pain, to severe, such as liver failure.
  • When diagnosed early enough, autoimmune hepatitis can be successfully managed with immunosuppressant drugs. But in severe cases, a liver transplant may be required.


Autoimmune hepatitis occurs when the body’s immune system produces antibodies that attack the liver cells. This damages the liver, causing inflammation and, eventually, scarring and organ failure.

The exact reasons why the immune system attacks its own liver are still not clear. A mixture of genetic and environmental factors, including exposure to certain viruses and drugs, are thought to be the most likely cause.

There are two types of autoimmune hepatitis:

  • Type 1: This is the most common form of autoimmune hepatitis. About half the people who have it also have another autoimmune condition, such as rheumatoid arthritis or celiac disease. This type can occur at any age.
  • Type 2: This is a much less common form of autoimmune hepatitis. It most often occurs in young children, but can sometimes be found in adults. It may also develop alongside another autoimmune disorder.


Autoimmune hepatitis affects each person differently. Some may have only a few symptoms, while others may experience many. These symptoms can also develop rapidly or gradually.

The following are some of the most common symptoms of autoimmune hepatitis:

  • Abdominal pain
  • Abnormal blood vessels on the skin (spider angiomas)
  • Dark-colored urine
  • Enlarged liver
  • Fatigue
  • Itching
  • Jaundice (yellowing of eyes and skin)
  • Joint pain
  • Light-colored stools
  • Loss of appetite
  • Loss of menstruation
  • Nausea and vomiting
  • Skin rashes


Diagnosing autoimmune hepatitis begins with a review of the patient’s medical history. A doctor or nurse will ask about any medications the patient is taking, their alcohol use, and whether they have an autoimmune disease. They will then conduct a physical exam to check for any signs of the disease.

The following are some other common ways of diagnosing autoimmune hepatitis:

  • Blood Tests: These look for liver enzymes and certain antibodies that are specific to autoimmune hepatitis. Doctors may also test for conditions that have similar symptoms to autoimmune hepatitis, such as viral hepatitis.
  • Imaging Tests: These form an image of the liver so that doctors can better detect signs of autoimmune hepatitis, such as cirrhosis. These tests may include a computerized tomography (CT) scan, an ultrasound, and magnetic resonance imaging (MRI). 
  • Liver Biopsy: This is a surgical procedure that removes a tiny portion of liver tissue so that doctors can examine it under a microscope to determine what is wrong.


The most common way to treat autoimmune hepatitis is to use medications that suppress the body’s immune system. This helps slow or stop it from attacking the liver. Doctors will usually begin by prescribing a high dose of corticosteroids, such as prednisone. After the first month, they gradually reduce the dose to avoid any unwanted side effects. Sometimes, doctors may also prescribe immunosuppressants such as azathioprine.

If autoimmune hepatitis has been diagnosed too late to avoid serious liver damage, then the only way to treat the condition will be through a liver transplantation. This involves removing the damaged liver and replacing it with a healthy donor liver. Afterward, it may still be necessary to take medication to suppress the immune system and keep it from attacking the new liver. 

Learn more about liver transplantations.


When it is detected and treated early enough, autoimmune hepatitis will often go into remission, which means that the liver is functioning better and symptoms are no longer present. That said,  because autoimmune hepatitis can be a long-term condition, treatment should only end with the approval of a doctor and while under close supervision. Otherwise, the disease may return.

Next Steps

Columbia doctors and medical staff have extensive experience diagnosing and treating all forms of hepatitis, including autoimmune hepatitis. Our center is also a nationwide leader in liver transplantations.

Call us at (877) LIVER MD/ (877) 548-3763 or use our online form to schedule an appointment.