When people think of hepatitis, they first think of viral hepatitis A, B, C and E, and of course alcoholic hepatitis and drug-related hepatitis. Many people are unfamiliar with autoimmune hepatitis. Indeed, autoimmune hepatitis is one of the newly identified diseases in recent years, which used to be called “lupus-like hepatitis”, according to research data, the disease has a high incidence in Europe and the United States, accounting for about 15-20% of chronic hepatitis. However, the disease is not uncommon in China, but in the early stage, people are not aware of this disease and it is not detected. In recent years, with the improvement of diagnosis and treatment technology in the immune and hepatology fields, the understanding of the clinical manifestations and pathogenesis of these diseases has been further enhanced, and the number of reports on this disease has increased. So, what is autoimmune hepatitis? Autoimmune hepatitis is a group of chronic hepatitis syndromes with liver pathological damage and abnormal liver function tests caused by the body’s immune response to attack its own liver tissue. In fact, it is a tragedy of “one’s own people fighting one’s own people” due to immune dysfunction. Why does autoimmune hepatitis occur? It is a genetically predisposed disease that can be triggered by environmental, drug, viral, or infectious factors in people with susceptibility genes. Patients have a deficiency in immune regulation, resulting in a response to their own hepatocyte antigens, which is dominated by cell-mediated cytotoxicity and an immune response resulting from the binding of hepatocyte surface-specific antigens to autoantibodies. The clinical manifestations of autoimmune hepatitis are very similar to those of viral hepatitis, firstly, abnormal liver function and elevated transaminases, secondly, jaundice, hepatosplenomegaly, and in severe cases, cirrhosis, ascites, hepatic encephalopathy, and bleeding from esophageal varices may develop. Therefore, it is often confused with viral hepatitis. However, compared to viral hepatitis, autoimmune hepatitis has its own personality. One: this guy is a bit “horny” and has a penchant for young women between the ages of 15 and 40 years old, and he can’t stop pestering them. According to statistics, the disease is more than 80% female. Therefore, when a young woman has elevated transaminases and no common cause of hepatitis can be found, the disease should be highly suspected. Secondly, autoimmune hepatitis is well camouflaged and unassuming, it eats up liver cells without moving and the liver is “silent”, making it difficult for the patient to detect. The onset of autoimmune hepatitis is generally slow, and patients initially feel weakness or loss of appetite, weight loss, elevated transaminases in laboratory tests, and jaundice at a certain stage of development, at which time it may have developed into severe hepatitis or even cirrhosis, and most of the treatment is too late. Thirdly, in terms of symptoms, the disease is essentially a case of “one’s own people beating one’s own people”. The liver bears the brunt of the disease, but other organs are also affected because immune cells are chopping and killing. Therefore, autoimmune hepatitis is often accompanied by other pathologies such as arthritis, colitis, nephritis, myocarditis, dermatomyositis, thyroiditis, dry syndrome, diabetes, etc. These pathologies are medically known as extrahepatic manifestations. Therefore, experienced doctors will look for clues from the extrahepatic manifestations and follow the trail to detect autoimmune hepatitis. Is there a specific treatment for autoimmune hepatitis? Because autoimmune liver disease is complex, often combined with multiple organ damage, and has a poor prognosis, there are no specific medications. For active autoimmune hepatitis, Western medicine is very clear treatment – immunosuppressive drugs (hormones), whose treatment requires long-term, a year or even more than several years, in addition to the long-term use of large amounts of hormones, causing clinical water and sodium retention, hypertension, diabetes, peptic ulcers, osteoporosis and other side effects, greatly affecting the patient’s physical and mental health. For this reason, we use a combination of Chinese and Western medicine, using Chinese herbal medicine to nourish the kidney and rub the liver, combined with immunomodulators to protect the liver, can improve the symptoms, signs and liver function, and can avoid the side effects of hormones, control the disease and delay the development of cirrhosis. If the disease has progressed to the stage of decompensated cirrhosis, liver transplantation is often required to prolong the patient’s survival when it is difficult to achieve satisfactory results with internal Chinese and Western medicine treatment. Therefore, early diagnosis, rational use of drugs and long-term standardized treatment are especially important. As for the prevention of the disease, it is difficult to formulate a practical prevention plan because autoimmune hepatitis and genetic factors are closely related. Although the disease is difficult to prevent, it can be controlled, so early detection and timely treatment are especially important. Patients who are found to have abnormal liver function, especially women, without risk factors such as alcohol, drugs, or changes in viral pathogenesis, should be highly suspicious of autoimmune hepatitis and go to the hospital for relevant tests and symptomatic treatment to avoid delaying the disease.