Autoimmune Liver Disease
Autoimmune liver diseases occur when the immune system mistakenly attacks the liver or bile ducts, leading to chronic inflammation. Symptoms may be mild or absent, but untreated disease can result in progressive fibrosis (scarring). With appropriate treatment and monitoring, good long-term control is often achievable.
Read more about autoimmune liver disease, diagnosis, and long-term treatment.
What is autoimmune liver disease?
Autoimmune liver disease occurs when the body’s immune system mistakenly attacks liver cells or the bile ducts. This leads to ongoing inflammation which, if untreated, can result in progressive liver scarring over time.
The main autoimmune liver conditions include autoimmune hepatitis and immune-mediated bile duct diseases, such as primary biliary cholangitis or primary sclerosing cholangitis. These conditions are not caused by infection, alcohol, or lifestyle factors.
How does autoimmune liver disease present?
Symptoms can be variable. Some people experience fatigue, joint pain, or vague abdominal discomfort, while others feel entirely well and are diagnosed following abnormal liver blood tests.
Primary biliary cholangitis can also present with severe itching or dry mouth and eyes, whereas primary sclerosing cholangitis can also present with jaundice.
Because symptoms can often be non-specific, diagnosis may be delayed without appropriate investigation.
How is autoimmune liver disease diagnosed?
Diagnosis usually involves a combination of:
- FibroScan to assess liver scarring
- Liver blood tests to assess inflammation and to look for immune markers
- Imaging to assess liver structure and bile ducts
- Occasionally, a liver biopsy to confirm the diagnosis
Accurate diagnosis is important to guide appropriate treatment.
How are they treated and monitored?
Treatment typically involves medication that reduces immune-driven inflammation and protects the liver from further damage. Most patients respond well to treatment when it is started early.
Primary biliary cholangitis is managed with oral medications that allows the bile to flow out through the bile ducts.
Long-term monitoring is essential, as autoimmune liver disease is usually a chronic condition.
With specialist care, many people maintain good liver health and quality of life.