HealthDiseases and Conditions

Autoimmune hepatitis. Clinical picture

Autoimmune hepatitis in most cases develops suddenly, and its clinical manifestations do not differ from those of acute hepatitis. At the initial stage of the disease a person feels a marked weakness. Darkening of the urine, intense jaundice are signs that accompany autoimmune hepatitis. Symptoms are quite clear even at the initial stage. For several months, a more complete clinical picture is unfolding.

In rare cases, autoimmune hepatitis is characterized by a gradual course. However, in this case, pain and heaviness prevail in the right hypochondrium, a person feels malaise, jaundice manifests itself slightly. In a number of patients, autoimmune hepatitis begins to develop with fever, as well as extrahepatic manifestations.

The unfolded clinical picture is characterized by severe weakness, skin itching, nausea, and lymphadenopathy. For pathology, jaundice is also characteristic (not constant, but increasing during exacerbations), an increase in the size of the spleen and liver. In a third of women, autoimmune hepatitis is accompanied by amenorrhea (lack of menstruation) and hirsutism (hair growth, as in men). In men, pathology can be accompanied by gynecomastia (development of the mammary glands, as in women). Among the main skin reactions are acne, capillaritis, lupus-like and palmar erythema and other lesions.

Autoimmune hepatitis is a progressive chronic lesion with the presence of hepatic-associated, serum autoantibodies. There is a process with a fairly extensive inflammation, hypergammaglobulinemia.

Autoimmune hepatitis. Treatment

Pathogenetic therapy of the disease is a therapy for glucocorticosteroids. Immunosuppressive therapy allows to lower the activity of pathological processes taking place in the liver, as a result of which the activity of T suppressors increases, the intensity of reactions contributing to the destruction of hepatocytes decreases.

As a rule, during therapy, such drugs as "Methylprednisolone" or "Prednisolone" are used. The initial daily dosage is sixty milligrams - in the first week, forty - in the second, thirty - in the third-fourth. Subsequently, the dosage is reduced to twenty milligrams, which is a maintenance dose. Supportive therapy is carried out until clinic-laboratory and histological parameters are normalized.

Decrease in the amount of the drug taken is carried out gradually. This takes into account the intensity of the clinical course and the level of serum markers.

Autoimmune hepatitis can be eliminated within six months. However, in many cases, therapy lasts a long period, and sometimes throughout life. In case of inefficiency of monotherapy, it is envisaged to include "Delagil", "Azathioprine", "Cyclosporine" in the regimen.

If immunosuppressive therapy fails to produce the expected result within four years, with multiple relapses, side effects from therapy, the question of liver transplantation may be raised .

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