autoimmune and liver failure

[bobcasey]

I have had autoimmune hep for the past 8 years with constant up and down alt ast levels. For the past 6-8 months my levels have continued to rise along with low platelet levels. My dr dianosed me with liver failure as of 2 days ago.  My abdomen is swollen so much I can not bend over or comfortably sit. My legs are swollen beyond what they can and I have a rash all over my body. When I go to the bathroom it is orange yellow on both counts.  I was put on steriods and imuran for treatment. What is the usual outcome of this? And timeline?  There is not a whole lot out there for autoimmune and failure that is answering anything.

[Thomas D Schiano, MD]

steroids and imuran can definitely predispose you to developing infections of any type

[bobcasey]

What kind of infection?  In dec I had surgery to remove a mass and uterus. I had a really bad infection from that. Then in January pneumonia for 3 months. Do you think there is any corlation to this?  I was on many different meds for this.

[Thomas D Schiano, MD]

if the platelets are low there is a chance you have developed cirrhosis.  The swelling is concerning for the liver disease to be decompensating.  It doesn't hurt to be placed on a liver transplant waiting list.  liver damage is potentially reversible if the autoimmune hepatitis is treated but your doctors have to maintain a fine line between giving you the immunosupressives to treat it and overdoing it and placing you at risk for infection