Autoimmune Liver Diseases

Overview

Autoimmune liver diseases include:

• Autoimmune hepatitis
• Primary sclerosing cholangitis
• Primary biliary cirrhosis

Autoimmune Hepatitis

You can develop autoimmune hepatitis quickly with severe jaundice and require hospitalization to stabilize your health. You may feel fatigue and pain in the upper abdomen which often do not appear until after liver damage occurs. Inflammation can damage cells and cause fibrosis.

Primary Sclerosing Cholangitis

Primary sclerosing cholangitis and primary biliary cirrhosis stem from problems with bile formation or bile flow to your gallbladder and small intestine. Both are rare conditions. With primary sclerosing cholangitis you have inflammation and scarring in your bile ducts that leads to jaundice and liver failure. Most people with this disorder are young and have ulcerative colitis, an inflammatory bowel disease (IBD).

Primary Biliary Cirrhosis

Primary biliary cirrhosis appears most often in women in their 40s and 50s. Your symptoms may include excessive itching and fatigue that can make your daily life difficult. You may have vague symptoms and low blood pressure, lack of mental clarity and depression.

Treatment

IU Health gastroenterologists and hepatologists have the expertise to treat autoimmune liver diseases and manage your symptoms so that you can maintain your health and normal lifestyle.

Your physicians participate in many of the latest advances in understanding autoimmune liver conditions. Through their affiliation with the Indiana University School of Medicine physicians conduct research studies into the genetic and environmental causes of autoimmune liver diseases through the Autoimmune Hepatitis Research Network. This work leads to clinical trials for new medicines and therapies to reduce symptoms, slow disease progression and put you in remission.

For children, physicians work in the pediatric gastroenterology program at Riley Hospital for Children at Indiana University Health, one of the oldest pediatric gastroenterology programs in the nation.

The following advances in diagnostic tests, treatments and symptom management for autoimmune liver diseases create more tolerable options for you or your child:

• Diagnosis. Your physicians may use a variety of tests and techniques to pinpoint your autoimmune liver disease diagnosis, including blood and imaging tests and biopsies.
• Blood tests. Your physician will check the status of your blood cell counts, liver function and the presence of autoimmune antibodies.
• Imaging tests. Your physician will use several different advanced procedures to obtain images of your liver and bile ducts. He or she may use:
  • Computed tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Ultrasound
  • Endoscopic ultrasound (EUS)
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Additional liver and biliary diagnostic imaging tests include: cholangiography, percutaneous transhepatic cholangiography (PTC), and magnetic resonance cholangiopancreatograph (MRCP).
• Biopsy
• FibroScan
• Medicines. Your physician will use a variety of therapies to treat autoimmune liver disorders including steroids, long-term immune suppression with non-steroidal medicines, antifibrotic medicines and medicines to combat symptoms of itching and fatigue.
• Stricture management
• Research. IU Health researchers conduct ongoing genetic and environmental research into autoimmune liver disease through the Autoimmune Hepatitis Research Network. They may recommend you for clinical trials of new medicines.