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What is autoimmune cirrhosis of the liver
Autoimmune cirrhosis of the liver is a disease that is a type of cirrhosis and occurs as a result of autoimmune hepatitis. The pathological process boils down to the fact that the body’s own immune cells, as a result of a number of reasons, begin to destroy healthy tissues of the organ.
According to statistics, the disease affects mainly women who are at the beginning of their reproductive age or at its end.
Symptoms of autoimmune cirrhosis of the liver
Often the disease can proceed without any pronounced symptoms and be diagnosed only at the final stage, or by chance during the passage of an ultrasound of the abdominal cavity.
The clinical picture of autoimmune cirrhosis is as follows:
Loss of strength and decreased performance;
Staining of the skin, sclera of the eyes and mucous membranes in yellow;
An increase in body temperature. For a long time, it can stay at subfebrile levels, but as the disease progresses, it rises up to 39 ° C;
Enlargement of the spleen and liver in size;
The occurrence of aching pains in the right hypochondrium, followed by an increase in their intensity;
Enlarged lymph nodes;
Damage to the joints, accompanied by swelling, pain and impaired functionality;
Inflammatory reactions on the skin;
Varicose veins of the esophagus, anorectal zone, umbilical region, cardia of the stomach;
Ascites is usually isolated. Sometimes it may be accompanied by an accumulation of fluid in the chest area;
Erosion and ulceration of the mucous membranes of the intestines and stomach;
Digestive disorders, in particular, nausea, accompanied by vomiting, unwillingness to eat, flatulence;
The accumulation of adipose tissue in the upper body and abdomen, while the limbs remain thin. In parallel, striae, erythema, darkening of skin areas, a bright blush on the cheeks are formed.
A distinctive feature of autoimmune cirrhosis is that it is not only accompanied by hepatic manifestations. The patient may experience symptoms characteristic of systemic lupus erythematosus, rheumatism, rheumatoid arthritis, systemic vasculitis, sepsis. That is why cirrhosis can remain undetected for a long time and not be subjected to adequate therapy.
Causes of autoimmune cirrhosis of the liver
This disease is quite rare. Chronic active hepatitis leads directly to the formation of cirrhosis.
Autoimmune cirrhosis of the liver can be caused by:
Previously transferred viral hepatitis A, B or C;
herpes virus;
Transferred Epstein-Barr virus;
Koryu.
In addition, in most patients (up to 85%), a certain antigen is found, which, as a result of one or another transferred viral infection, leads to the formation of cirrhosis. Often, such patients have ulcerative colitis, synovitis, thyroiditis, Graves’ disease and other autoimmune diseases, which can also become indirect causes of the development of liver pathology.
Diagnosis of autoimmune cirrhosis
In order to make a diagnosis, it is necessary to focus on specific criteria:
Firstly, the patient’s blood should not contain any hepatitis viruses;
Secondly, it must be established that the person does not abuse alcohol, does not take drugs that are toxic to the liver, and has not undergone a blood transfusion;
Thirdly, he should have elevated liver tests of ASAT (AST) and ALAT (ALT) and titers of certain antibodies.
If all these evaluation criteria are positive, then it makes sense to suspect autoimmune cirrhosis. For morphological examination, a liver biopsy is required.
Treatment of autoimmune cirrhosis of the liver
Therapy of the disease is reduced to taking glucocorticosteroids, which have immunosuppressive properties. This allows you to ensure that the pathological reactions in the liver will be slowed down, and the aggressive immune bodies produced by the body will stop destroying hepatocytes so actively.
The most commonly prescribed immunosuppressants are prednisolone and methylprednisolone. Therapy begins with taking high doses of drugs (up to 60 mg in the first week) with a gradual decrease in it and bringing it up to 20 mg a month later. This dosage is taken for the entire time until the normalization of clinical, laboratory and histological parameters occurs. As for the duration of treatment, it can last for several months, ranging from six months to lifelong therapy.
If a therapeutic effect cannot be achieved, then a change in the treatment regimen is necessary. This applies to the introduction of additional drugs. Combined therapy gives the best effect. Often, delagil, cyclosporine, azathioprine are used as adjuvants.
However, it happens that even complex therapy does not make it possible to achieve the desired effect. With frequent relapses of the disease and no effect for 4 years, a decision is made on the need for transplantation of the affected organ. Liver transplantation makes it possible to achieve a stable remission no worse than drug therapy.
As for the prognosis, in the absence of a therapeutic effect, the disease will continuously affect the liver. Remissions in this case do not occur, as a result, a person dies due to the development of serious complications, for example, due to liver failure. At the same time, the prognosis is rather unfavorable and a lethal outcome is recorded in 50% of patients five years after the diagnosis.
Patients with such a diagnosis need to reconsider their lifestyle, protect themselves from stress as much as possible, refuse to take medications if possible, follow a diet and not do seasonal vaccinations. Reducing physical activity is an important condition for maintaining the normal functioning of the liver.