Autoimmune hepatitis
A chronic disease in which the immune system attacks the liver, causing ongoing inflammation and, if untreated, scarring. It often shows up as raised liver enzymes with autoantibodies and a high IgG, and it usually responds well to treatment that calms the immune system.
What it is
Autoimmune hepatitis is a condition in which the body's own immune system mistakenly attacks the liver cells, causing persistent inflammation (hepatitis). Left untreated, this ongoing damage can progress to scarring (fibrosis and eventually cirrhosis) and liver failure, so recognising and treating it matters. It can affect anyone but is more common in women, and it sometimes occurs alongside other autoimmune conditions. Its presentation varies widely: some people are found by chance to have raised liver enzymes on a routine blood test with no symptoms; others have tiredness, aching joints, nausea, jaundice (yellowing) or the signs of more advanced liver disease; and occasionally it presents suddenly as acute hepatitis. The typical blood picture is raised liver enzymes (ALT and AST), a characteristically high immunoglobulin (IgG), and one or more autoantibodies such as ANA, anti-smooth-muscle or anti-LKM. The diagnosis brings these together and usually needs a liver biopsy to confirm the pattern and assess how much damage has occurred, after excluding other causes such as viral hepatitis. The good news is that autoimmune hepatitis usually responds well to treatment that suppresses the immune attack (steroids and other immune-modulating medicines), which controls the inflammation and protects the liver over the long term.
Key lab markers
- ALT and AST — liver enzymes, typically raised, reflecting liver-cell inflammation.
- IgG (immunoglobulins) — characteristically high; a useful clue and a marker to follow.
- ANA, anti-smooth-muscle antibody, anti-LKM — autoantibodies that support the diagnosis.
- Bilirubin, albumin and clotting (INR) — assess liver function and severity.
- Viral hepatitis tests — to exclude other causes of hepatitis.
- A liver biopsy — usually needed to confirm and stage the disease.
Symptoms
- Often none early on — found through raised liver enzymes
- Tiredness and general unwellness
- Aching joints
- Nausea, poor appetite
- Yellowing of the skin or eyes (jaundice)
- Discomfort in the upper right abdomen
- In advanced disease: swelling, easy bruising, and other signs of liver damage
Related lab panels
When to discuss with a doctor
Autoimmune hepatitis is often first suspected when routine or investigative blood tests show unexplained, persistently raised liver enzymes, prompting a search for the cause. Unexplained abnormal liver tests, or symptoms such as tiredness, jaundice or aching joints with abnormal liver blood tests, should be assessed by a doctor. A pattern of raised ALT and AST with a high IgG and a positive autoantibody strongly suggests it, but confirmation usually needs a liver specialist and a biopsy, and other causes (especially viral hepatitis) must be excluded first. Diagnosis matters because untreated autoimmune hepatitis can scar the liver, whereas treatment usually controls it well. Mediora.AI can surface the combined pattern — raised ALT and AST, a high IgG, and a positive ANA — that points toward autoimmune hepatitis; the diagnosis and treatment belong with your doctor and a liver specialist.