Q: How can an autoimmune disease of the liver be detected? What are the symptoms? Is there any additional information worth knowing?
A: The main autoimmune diseases of the liver are primary biliary cirrhosis, primary sclerosing cholangitis and autoimmune hepatitis, and each one may manifest with similar symptoms and examination alterations as well as specific disorders and specific alterations of some blood tests. In particular, primitive biliary cirrhosis and primary sclerosing cholangitis are cholestatic diseases caused by an “autoimmune” injury to the biliary tract and both are characterized by an alteration of cholestasis indices, namely the gamma-glutamyltranspeptidase (GGT), the phosphatase alkaline (FA), and bilirubin. A cholestatic disease can manifest with itching and jaundice. Primary biliary cirrhosis is characterized also by the presence of anti-mitochondrial (AMA) autoantibodies and often high serum levels of type M immunoglobulins. In comparison, autoimmune hepatitis is an autoimmune aggression due to hepatocyte and it is characterized by a typical rise in induced hepatic necrosis, namely the transaminases ALT and AST, as well as gamma globulin and type G immunoglobulin in serum. Finally, the serum of patients with autoimmune hepatitis is filled with various autoantibodies, including anti-nuclear antibodies (ANA) and anti-smooth muscle antibodies (SMA), as well as type 1 autoimmune hepatitis and anti-LKM type 2 autoimmune hepatitis.
