Autoimmune hepatitis is an inflammation of the liver caused by the immune system attacking the liver itself. For reasons not yet clear, the body identifies the liver as a foreign agent and mounts an immune response against it. Autoimmune hepatitis is classified as Type I or Type II. Type I autoimmune hepatitis can occur at any age, while Type II tends to affect younger children. The distinction between the two types is often made through blood tests and clinical evaluation.
There is considerable variation in the presentation of autoimmune hepatitis in children. Sometimes, there are few non-specific symptoms, and at other times, the presentation mimics acute liver failure, as detailed above. Some children may suffer from inflammation for months or even years without being aware of it. Potential symptoms can include fatigue, loss of appetite, skin and eye jaundice, or dark urine.
The diagnosis of autoimmune hepatitis is usually based on blood tests and liver biopsy. Additional tests may be needed to rule out other disorders.
The treatment for autoimmune hepatitis is centered around administering medications that help modulate the immune system. Treatment options include prednisone and typically azathioprine or mercaptopurine. Other available medications include budesonide or tacrolimus. Treatment usually spans an extended period to prevent disease flare-ups. Sometimes, dosages of medications are adjusted during treatment to strike a balance between effectiveness and minimizing side effects. Proper treatment at specialized centers not only prevents further liver damage but has also demonstrated the ability to partially reverse existing damage.