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Complications
By Mayo Clinic staff
Autoimmune hepatitis may be associated with a variety of other autoimmune diseases, including:
- Pernicious anemia. Associated with a number of autoimmune disorders, pernicious anemia occurs when a lack of vitamin B-12 interferes with your body's ability to form red blood cells.
- Hemolytic anemia. In this type of anemia, your immune system attacks and breaks down red blood cells faster than your bone marrow can replace them.
- Ulcerative colitis. This inflammatory bowel disease can cause severe bouts of watery or bloody diarrhea and abdominal pain.
- Autoimmune thyroiditis (Hashimoto's thyroiditis). In this condition, the immune system attacks the thyroid gland.
- Rheumatoid arthritis. Rheumatoid arthritis occurs when the immune system attacks the lining of your joints, leading to stiffness, pain, swelling, and sometimes deformity and disability.
- Celiac disease. This disease causes an abnormal reaction to gluten, a protein found in many grains. Eating gluten sets off an immune response that damages the small intestine.
Complications of liver damage
Autoimmune hepatitis that goes untreated can cause permanent scarring of the liver tissue (cirrhosis). Complications of cirrhosis include:
- Increased blood pressure in the portal vein. Blood from your intestine, spleen and pancreas enters your liver through a large blood vessel called the portal vein. If scar tissue blocks normal circulation through your liver, this blood backs up, leading to increased pressure within the portal vein (portal hypertension).
- Enlarged veins in your esophagus (esophageal varices). When circulation through the portal vein is blocked, blood may back up into other blood vessels — mainly those in your stomach and esophagus. The blood vessels are thin walled, and because they're filled with more blood than they're meant to carry, they're likely to bleed. Massive bleeding in the esophagus from these blood vessels is a life-threatening emergency that requires immediate medical care.
- Fluid in your abdomen (ascites). Liver disease can cause large amounts of fluid to accumulate in your abdomen. Ascites can be uncomfortable and may interfere with breathing and is usually a sign of advanced cirrhosis.
- Liver failure. This occurs when extensive damage to liver cells makes it impossible for your liver to function adequately. At this point, a liver transplant is the only option.
- Liver cancer. People with cirrhosis have an increased risk of liver cancer.
References
- Czaja AJ, et al. Advances in the diagnosis, pathogenesis, and management of autoimmune hepatitis. Gastroenterology. 2010;139:58.
- Krawitt EL. Pathogenesis of autoimmune hepatitis. http://www.uptodate.com/index. Accessed Feb. 9, 2012.
- Manns MP, et al. Diagnosis and management of autoimmune hepatitis. Hepatology. 2010;51:1.
- Autoimmune hepatitis. National Institute for Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/autoimmunehep/. Accessed Feb. 9, 2012.
- McPhee SJ, et al. Current Medical Diagnosis & Treatment 2012. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=1. Accessed Feb. 16, 2012.
- Luxon BA. Diagnosis and treatment of autoimmune hepatitis. Gastroenterology Clinics of North America. 2008;37:461.
- Mieli-Vergani G, et al. Autoimmune hepatitis. Nature Reviews. Gastroenterology and Hepatology. 2011;8:320.
- Greenberger NJ, et al, eds. Current Diagnosis & Treatment: Gastroenterology, Hepatology, & Endoscopy. New York, N.Y.: McGraw-Hill; 2009. http://www.accessmedicine.com/content.aspx?aID=6204532. Accessed Feb. 16, 2012.
- Teufel A, et al. Concurrent autoimmune diseases in patients with autoimmune hepatitis. Journal of Clinical Gastroenterology. 2010;44:208.
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