NewYork-Presbyterian

Liver & Biliary Diseases

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Autoimmune Hepatitis

When the Liver Is Under Attack

In people with autoimmune hepatitis, immune cells inappropriately mistake the liver's normal cells as abnormal and attack them. Over time, this can lead to inflammation, scarring (fibrosis), impaired liver function, and even cirrhosis (extensive scarring), which can result in liver failure, and death if not treated. Some people may eventually need a liver transplant. The liver disease specialists at NewYork-Presbyterian’s Center for Liver Disease and Transplantation are experienced in diagnosing and treating autoimmune hepatitis.

Causes of autoimmune hepatitis

The causes of autoimmune hepatitis are not known. Certain genetic or environmental factors (such as viral or bacterial infections or the use of certain medications) may trigger the disease. It is also more common in people with another autoimmune disease in themselves or their family members.

Signs & Symptoms of Autoimmune Hepatitis

Most cases of early autoimmune hepatitis have no symptoms and can only be detected by routine blood tests (liver function tests or LFTs). The symptoms of autoimmune hepatitis differ depending on its severity and may include:

Fatigue (the most common symptom reported)
Nausea
Loss of appetite
Diarrhea
Jaundice (yellowing of the skin and whites of the eyes)
Itchy skin, dark urine, pale stools, disorientation, abdominal swelling, and leg swelling if the disease gets worse

Tests & Diagnosis

We typically use these tests to diagnose autoimmune hepatitis:

Physical examination
Blood tests of liver function
Fibroscan® (a special ultrasound that helps determine the amount of scarring in the liver)
Ultrasound
Liver biopsy

Our Approach to Care

Your care team includes hepatologists (liver specialists), gastroenterologists, liver surgeons (should you need a transplant), nurses, physician assistants, registered dietitians, social workers, and others with the compassion and skills to treat people with autoimmune hepatitis and other liver diseases. If your autoimmune hepatitis is related to another condition, such as ulcerative colitis or another autoimmune disease, we can link you with the doctors you need to care for that disorder as well.

Treatment of autoimmune hepatitis

Our teams offer medical therapies as well as liver transplantation for people with autoimmune hepatitis when the liver disease has progressed to an advanced state.

Medical treatment. Your doctor will likely start treating you with steroids such as prednisone or budesonide, which can control your disease's progression and prevent or even reverse liver damage. You may also receive an immune suppressant such as azathioprine, mycophenolate, or tacrolimus for more long-term control, which allows most people to be taken off steroids. We will continue to monitor your liver function carefully and determine the lowest dose of immunosuppressant medication you need to control your disease. We will also work with your primary care doctor to monitor and address any complications of long-term steroid or immunosuppressant use, such as osteoporosis and cancer.

Liver transplantation. In some people, the inflammation and liver damage of autoimmune hepatitis cannot be controlled with medication alone. In these cases, our doctors may suggest a liver transplant. At NewYork-Presbyterian, we have exceptional expertise in liver transplantation and the use of a variety of approaches, including living donor liver transplantation.

Why Choose Us

Autoimmune hepatitis is a rare liver disease, and doctors at other hospitals may not have as much experience diagnosing and treating it as the liver specialists at NewYork-Presbyterian. You can receive all the care you need in one medical center — whether that be medical treatment, a liver transplant, or care for a related illness. Call us today to learn about the care we can provide to you.