Autoimmune Liver Disease: a Silent Killer:Better To Have Early Detection & Early Treatment

By 1 2 1 News Reporter

Chandigarh 03^rd July:- People equate liver disease with "Piliya" or "Jaundice". They are also aware that it can be caused by viruses- A, B, C, D, and E. General awareness about another entity of liver disease that is autoimmune liver diseases, on other hand is considered to be almost non-existent.

The Department of Immunopathology, PGI, Chandigarh has contributed extensively to the screening of autoimmune liver disease in North-Indian population, and has therefore documented that there is a rise in the incidence of Autoimmune Hepatitis in North India. This is a condition in which, due to known genetic susceptibility, a person begins to form known auto-antibodies and mounts a destructive immune response against the liver and/or the billiary system. This disease is more common in women, but can also occur in males as well, and does not spare any age group. Common presentation of the disease includes jaundice, unusual tiredness, itching of skin, pain/distension of the abdomen, or there can be other vague symptoms that people often neglect. A liver function test asked for, by the hepatologist shows deranged liver enzymes and screening for auto-antibodies such as anti-nuclear antibodies (ANA), anti-smooth muscle antibodies (SMA), and anti-mitochondrial antibodies (AMA-M2) helps to classify the disease into Type I AIH, Type II AIH or AMA-M2 positive liver diseases. The department has also been able to show that the genetic susceptibility (i.e. HLA-association) for the different types of AIH is different. All above findings have been published in international journals.

While characterizing these diseases, it was noticed that patients presenting to rheumatologists, with joint pains, or to the endocrinologist with diabetes and/or hypothyroidism may also have co-existent Autoimmune Hepatitis. Thus, this disease could silently accompany other autoimmune diseases. In North Indians, this disease progresses fairly rapidly in 5-10 years to cirrhosis and liver failure, as documented by us.

 In the last 15 years, we have covered 25,000 individuals for autoimmune liver disease. These patients are referred by clinicians who suspect this condition. The patients require a liver biopsy for confirmation of the disease.