Today, the incidence of many diseases is increasing. These diseases include autoimmune diseases. There is a special signaling system between the cells that are the components of our body. Thanks to these signals and communication, cells recognize each other. The situation we call autoimmunity is the state of our immune system attacking it by considering a tissue or organ system as foreign due to a disorder in this intercellular communication. As a result of this attack, tissue damage occurs. This situation can limit itself and progress rapidly, causing deterioration of functions. If this situation is in the liver, autoimmune liver diseases are mentioned. The incidence of autoimmune diseases is increasing all over the world and in Turkey. This may be due to lifestyle changes, our eating habits and environmental factors. However; Today, with the development of laboratory techniques, it can be detected more easily, which may play an active role in our seeing the diseases more frequently. Autoimmune wars, which form the basis of the majority of liver patients in Turkey, can also change the course of many liver diseases. In this content, where you can find answers to many questions such as what are autoimmune liver diseases, how these diseases give symptoms, how autoimmune liver diseases are treated, you will also have a lot of information about "diagnosis and treatment of autoimmune liver diseases".
Contents
What are Autoimmune Liver Diseases?
Various autoimmune liver diseases, including autoimmune hepatitis (AIH), primary biliary cirrhosis (PBS), and primary sclerosing cholangitis (PSC), are common nowadays. These autoimmune liver diseases, which have different causes and symptoms, can progress to liver failure and cancer.
Primary sclerosing cholantitis (PSC), one of the autoimmune liver diseases, occurs with inflammation of the biliary tract, just like primary biliary cirrhosis. As with most autoimmune diseases, these diseases also contain autoantibodies. However, in primary sclerosing and biliary cholangitis, the biliary tract is diseased, whereas in autoimmune hepatitis, damage to the liver cells is prominent.
- Liver Diseases
- Acute Hepatitis
- Jaundice
- Chronic Hepatitis (Hepatitis B, Hepatitis C, Hepatitis D)
- Autoimmune Liver Diseases
- Alcoholic Liver Disease
- Fatty Liver
- Cirrhosis
- Primary Biliary Cirrhosis
- Hepatic Encephalopathy
- Liver Cancer
What Are the Symptoms of Autoimmune Liver Diseases?
- Weakness
- Anorexia
- Nausea
- Yellowing of the whites of the eyes, skin color,
- darkening of urine color
Symptoms of autoimmune liver diseases, which have many common symptoms such as itching, will be given more clearly in the detailed descriptions of the disease.
Autoimmune Liver Diseases 1: Autoimmune Hepatitis
AIH is an autoimmune liver disease that is relatively rare and difficult to diagnose, treat, and follow-up due to its heterogeneous clinic. Although the age range is wide in autoimmune hepatitis, the incidence rate of which is known as 1525/100,000 in European countries today, it is "more" that this disease is seen in women in terms of gender. Autoimmune hepatitis, which can be seen in both sexes, usually threatens women of reproductive age. Autoimmune hepatitis with fulminant onset can also be seen as silent and subclinical in the patient. The aim of treatment in autoimmune hepatitis with exacerbations is “complete remission”, that is, to provide complete recovery and to prevent progressive liver disease. However, if long-term treatment is required, it should also be considered whether the patient is of reproductive age or has children. The most commonly used treatment method in the treatment of autoimmune hepatitis is Azothiopurine (AZT) and corticosteroid (KS) drug treatments.
Autoimmune Liver Diseases 2: Primary Biliary Cholangitis
One of the most important factors in the occurrence of primary biliary cholangitis (PBK), known as chronic cholestatic liver disease developing on an autoimmune basis, is genetic predisposition. The incidence of PBK increases in first-degree relatives of patients diagnosed with PBK, that is, primary biliary cholangitis. Primary biliary cholangitis, which is more common in women, can be observed between the ages of 30 and 65. Although primary biliary cholangitis is known as an "accidental" liver disease without symptoms, 50-60% of patients are asymptomatic. Primary biliary cholangitis, which gives symptoms such as itching and fatigue, can often be seen together with other autoimmune diseases. For example; Physical examination findings of primary biliary cholangitis, which can be seen together with Sjögren's syndrome and Hashimoto's thyroiditis, may vary according to the stage of the disease. Because, while physical examination findings are normal in the early stages, hepatomegaly, splenomegaly, jaundice and itching may be seen in the later stages. To diagnose primary biliary cholangitis, blood tests and autoantibody levels should be checked. Definitive diagnosis is made by liver biopsy. Diagnosis of the disease
Abdominal ultrasonography may be preferred to see accompanying pathologies or for differential diagnosis. The treatment of primary biliary cholangitis is done for two purposes, the first is the treatment of the primary disease and the second is the treatment of complications.
Autoimmune Liver Diseases 3: Primary Sclerosing Cholangitis
Primary sclerosing cholangitis, which begins with involvement of the intra and extrahepatic medium and large biliary tract, is known as a chronic progressive disease. Primary sclerosing cholangitis with inflammation, fibrosis and narrowing of the bile ducts is an autoimmune liver disease whose cause is still unknown. Many of the primary sclerosing cholangitis cases, which are likely to be observed together with many inflammatory diseases such as ulcerative colitis, are detected "incidentally". Primary sclerosing cholangitis, which may not cause any symptoms, can be detected by suspecting after high levels of ALP and GGT in the blood test. Bilirubin will increase when primary sclerosing cholangitis, which is diagnosed by performing a liver biopsy, progresses. Medical treatment of primary sclerosing cholangitis is aimed at increasing bile fluidity, but liver transplantation is required to "definitely" get rid of the disease. In addition, as in other autoimmune liver diseases, "immune system suppressive" drugs may be preferred.