autoimmune hepatitis

[hemaloud]

Hi,

My husband and myself went for a regular health check. His Liver function test parameters were above normal and he is said to be deficient to vitamin b12. we were then recommended to see a gastro doctor. He suggested for Endoscopy, sonography and various blood test, that included autoimmune hepatitis. His sonography suggested fatty liver, his endoscopy suggested hernia and all the blood test were normal except autoimmune hepatitis. Here in one of the tests, LC-1 (cystosolic antigen) was borderline positive. Can anyone explain me what does that mean.

Thanks in advance,
Hema

[mikesimon]

Autoimmune Hepatitis can often be managed for years but, it cannot cured. Fairly recently the drug Azathioprine has been added to Prednisone to treat AIH with the goal being to able to withdraw the Prednisone in time. Long term Prednisone has serious side effects but, Azathioprine has its own side effects as well - which you can read about in the link below..
Treatment is often stopped once the AIH is in remission and it can stay in remission for years although most people see activity within 2 years and must re-start treatment. And some patients are advised not to treat if liver damage is not advanced and other criteria are not met. Eventually though, they will have to treat at some point.
This disease is a complex disease and I agree with Frankie that you should be seeing a hepatologist. There are often other autoimmune disorders seen in patients with AIH. I believe colon issues are not uncommon - eg...ulcerative colitis

From what you said I don't see enough evidence to support a definitive diagnosis of AIH. Perhaps there are additional blood results which further suggest Autoimmune Hepatitis.

The following is from: http://emedicine.medscape.com/article/172356-overview

Evidence for an autoimmune pathogenesis includes the following:
   * Hepatic histopathologic lesions composed predominantly of cytotoxic T cells and plasma cells
    * Circulating autoantibodies (ie, nuclear, smooth muscle, thyroid, liver-kidney microsomal, soluble liver antigen, hepatic lectin)
    * Association with hypergammaglobulinemia and the presence of a rheumatoid factor
    * Association with other autoimmune diseases
    * Response to steroid and/or immunosuppressive therapy

The autoantibodies described in these patients include the following:
    * Antinuclear antibody (ANA), primarily in a homogenous pattern
    * Anti–smooth muscle antibody (ASMA) directed at actin
    * Anti–liver-kidney microsomal antibody (anti–LKM-1)
    * Antibodies against soluble liver antigen (anti-SLA) directed at cytokeratins types 8 and 18
    * Antibodies to liver-specific asialoglycoprotein receptor or hepatic lectin
    * Antimitochondrial antibody (AMA) - AMA is the sine qua non of primary biliary cirrhosis (PBC) but may be observed in the so-called overlap syndrome with autoimmune hepatitis.
    * Antiphospholipid antibodies10

Good luck,
Mike

[franke566]

I went to Autoimmune Hepatitis and found a number of sites with prognosis' etc and it looks like your hubby will be okay.  the one specific site gave the treatment as a series of medications: Muran. Prednisone and steiroids.  Highly treatable is what I read and he needs to have his thyroid checked as that is linked and maybe even arthritis of the joints-your husband is producing antibodies that for one reason or another are attacking the toxins in his liver-trouble is these antibodies don't know the difference between the toxins and the good cells so they are attacking the organ itself .  I hope this helps, be sure to follow up with his doctor-preferrably a Hepatologist.  Best of luck to you both franke