Autoimmune cirrhosis of the liver
Content:
- What is Autoimmune Liver Cirrhosis
- Symptoms of autoimmune liver cirrhosis
- Causes of autoimmune liver cirrhosis
- Diagnosis of autoimmune cirrhosis
- Treatment of autoimmune cirrhosis of the liver
What is Autoimmune Liver Cirrhosis
Autoimmune cirrhosis of the liver is a type of cirrhosis that 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 the healthy tissues of the organ.
According to statistics, the disease affects mainly women who are at the beginning of reproductive age or at the end.
Symptoms of autoimmune liver cirrhosis
Often, the disease can proceed without any pronounced symptoms and be diagnosed only at the final stage, or accidentally during an abdominal ultrasound scan.
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 yellow;
- Increase in body temperature. For a long time it can stay at subfebrile levels, however, as the disease progresses, it rises up to 39 ° C;
- Enlargement of the spleen and liver in size;
- The onset of aching pains in the right hypochondrium, followed by an increase in their intensity;
- Swollen lymph nodes;
- The defeat of the joints, accompanied by swelling, pain and impairment of their functionality;
- Inflammatory reactions on the skin;
- Varicose veins of the esophagus, anorectal zone, umbilical region, cardiac part of the stomach;
- Ascites is usually isolated. Sometimes it can be accompanied by the 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, and a bright blush on the cheeks are formed.
A distinctive feature of autoimmune cirrhosis is that it is accompanied not only 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 undergo adequate therapy.
Causes of autoimmune liver cirrhosis
This disease is quite rare. Chronic active hepatitis directly leads to the formation of cirrhosis.
Autoimmune cirrhosis of the liver can be caused by:
- Previously transferred viral hepatitis A, B or C;
- Herpes virus;
- The transferred Epstein-Barr virus;
- Measles.
In addition, in the majority of 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, you need to focus on specific criteria:
- First, viruses of any hepatitis should not be present in the patient's blood;
- 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 blood transfusions;
- Thirdly, he should have increased liver function tests ACaT (AST) and ALaT (ALT) and titers of certain antibodies.
If all of these evaluation criteria are positive, then it makes sense to suspect autoimmune cirrhosis. For morphological examination, liver biopsy is required.
Treatment of autoimmune cirrhosis of the liver
Therapy of the disease comes down to taking glucocorticosteroids, which have immunosuppressive properties. This makes it possible to ensure that the pathological reactions in the liver will be slowed down, and the aggressive immune bodies produced by the body will stop so actively destroying hepatocytes.
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 and bringing it up to 20 mg a month later. This dosage is taken throughout the entire time until the normalization of clinical, laboratory and histological parameters. As for the duration of treatment, it can last for several months, ranging from six months and ending with 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. Complex therapy gives the best effect. Delagil, cyclosporine, azathioprine are often 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. A liver transplant 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. In this case, remissions 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.
If the patient seeks medical help on time and the treatment has the proper effect, then the survival rate is 20 or more years in 80% of patients with autoimmune cirrhosis.
Patients with such a diagnosis need to revise their lifestyle, maximally protect themselves from stress, if possible, refuse to take medications, follow a diet and not do seasonal vaccinations. Reducing physical activity is essential for maintaining normal liver function.
The author of the article: Gorshenina Elena Ivanovna | Gastroenterologist
Education: Diploma in the specialty "General Medicine" received at the Russian State Medical University named after N. I. Pirogova (2005). Postgraduate studies in the specialty "Gastroenterology" - educational and scientific medical center.
