The liver is a fundamental organ for the proper functioning of our organism. Among its main functions is that of purifying substances that our own body generates and that can be toxic, and it processes the products that have been absorbed in digestion so that they can be used by our body. Many medicines that we consume are also processed and purified by the liver, but the liver not only purifies, it is also in charge of producing many proteins that are essential for the proper functioning of our body, such as coagulation factors. Finally, it contributes to digestion by producing bile, which facilitates intestinal absorption, especially of fats.
Liver diseases: how they occur and how to distinguish between them
The mechanisms that can damage the liver are varied. On the one hand, there are infections that can affect the liver and, among these, the best known are viral hepatitis (A, B, C). The liver can also be damaged by the consumption of toxic substances, especially by the excessive consumption of alcohol or by some medications. Sometimes it is also damaged by accumulation of substances that are deposited in it, such as iron or copper. The accumulation of fat in the liver can, in some people, end up developing problems. It is not a frequent situation but, if sufficient blood did not arrive at the liver, this one would not work well (the same thing that happens to the brain or to the heart). Cancer can develop in the liver or metastasis of a cancer originating in another organ can appear. And, a separate chapter would be immunological diseases, among which autoimmune hepatitis stands out. As can be seen, the causes are very diverse.
Symptoms that warn of the possibility of liver disease
The patient with liver disease may report symptoms such as fatigue, yellow pigmentation of the skin and mucous membranes (jaundice), dark urine, etc. Internal medicine specialists should ask the patient about his or her toxic habits, consumption of medications, or family history, which can guide us to the origin of the problem. The physical examination of the patient often reveals fundamental data that will help us in the diagnosis. Finally, the Internal Medicine specialist will use complementary laboratory and imaging tests that should confirm what is wrong with our liver.
What is autoimmune hepatitis and how does it manifest itself in the patient?
Autoimmune hepatitis is a disease in which our own immune system attacks the liver. The function of the immune system is to defend us from external agents that can cause us diseases, such as viruses or bacteria. For this defense to be adequate, the first thing that must happen is that the immune system must clearly identify who is an enemy (external agent) and who is an ally (our own cells).
For reasons that are not entirely clear, the immune system sometimes gets confused. In autoimmune hepatitis this confusion occurs with our liver cells, which are self-attacked, but there are many examples in other organs or structures of our body that are attacked, such as joints (rheumatoid arthritis), intestine (Crohn’s disease), thyroid (autoimmune thyroiditis), etc.
The patient with autoimmune hepatitis may feel tired, sometimes jaundiced, and may even have lost his appetite. The symptoms are not very different from those of hepatitis caused by a virus. There may be data in the physical examination that make us suspect autoimmune hepatitis but, in general, it is the analysis that usually confirms that it is an autoimmune disease.
Importance of treating autoimmune hepatitis
The treatment of autoimmune hepatitis aims, in a way, to block the immune system that is damaging the liver, and this is achieved with immunosuppressive drugs. It is very important to treat patients because, if this aggression to the liver by our immune system is perpetuated, it can end up triggering liver cirrhosis.
The response to medical treatment is usually very favorable soon after initiation. In any case, treatment should be maintained for several months, in order to try to avoid relapses that may occur. In patients who relapse when treatment is stopped, it is probably reasonable to keep them on the minimum amount of drug that will inactivate the disease.