Autoimmune liver diseases are a group of liver lesions due to autoimmune abnormalities, highlighted by the presence of multiple autoantibodies in the serum of patients who present with liver injury. Although the etiology and pathogenesis are unclear, autoimmune phenomena can be observed to varying degrees in patients with this group of diseases, in which the immune system mistakenly identifies its own tissues as foreign invaders and attacks them due to recognition or other reasons. As the most important substantial organ of human metabolism, the liver mainly consists of liver parenchymal cells, blood vessels and bile ducts. Autoimmune liver diseases can be divided into four major categories: autoimmune hepatitis (AIH), which is mainly hepatocellular damage, and primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC), which are mainly intrahepatic bile duct damage; they also include the newly added IgG4-associated cholangitis (IAC) in recent years. If any two of the first three types occur together, they are called overlapping syndromes. Clinically, AIH-PBC overlap syndrome is the most common. The two most common types of autoimmune liver disease are described below. Autoimmune hepatitis (AIH): AIH is a chronic progressive autoimmune liver disease that is more common in female patients, mostly with an insidious onset. Common manifestations include malaise, nausea, vomiting, upper abdominal discomfort or pain, arthralgia, myositis, and rash. Some patients have no obvious clinical symptoms and signs and are only detected when biochemical tests are done for liver function abnormalities. A small number of patients present with acute, subacute or even fulminant onset. Some patients have other autoimmune diseases, such as dry syndrome, rheumatoid arthritis, etc. The main laboratory abnormalities are elevated serum aminotransferases, hypergammaglobulinemia and autoimmune antibody inflammation; histopathological examination mainly shows interfacial hepatitis and plasma cell infiltration in the hilar region. The treatment of AIH is mainly based on glucocorticoids (prednisone), and the dose of hormone should follow the principle of individualization, and the treatment should be continued for more than 3 years to prevent recurrence of the disease. Azathioprine and other drugs are commonly used for maintenance therapy. Patients for whom conventional combination regimens are ineffective can be treated with cyclosporine A, methotrexate and mycophenolate, which have been reported to be effective. Liver transplantation should be promptly performed in patients with acute onset manifesting as fulminant liver failure that is ineffective with hormonal therapy, and in patients with chronic onset manifesting as liver failure during or after conventional therapy. Primary biliary cirrhosis (PBC) PBC occurs in women over 50 years of age due to inflammation of the interlobular bile duct granulomas in the liver, resulting in reduced destruction of small bile ducts, bile stasis, and eventually fibrosis, cirrhosis and even liver failure. Clinical manifestations can be seen as weakness, pruritus, portal hypertension, osteoporosis, jaundice, fat-soluble vitamin deficiency, and recurrent asymptomatic urinary tract infections. Most cases may be diagnosed without clinical symptoms. In addition, other autoimmune diseases, such as dry syndrome, systemic sclerosis, autoimmune thyroiditis, etc., are often associated with the disease. The most common biochemical abnormality in PBC is elevated hepatogenic serum alkaline phosphatase and gamma glutamyl transpeptidase. Although a few patients have elevated serum bilirubin, mainly direct bilirubin, at the time of diagnosis, hyperbilirubinemia is mostly an advanced manifestation of PBC and indicates a poor prognosis for PBC. The standard treatment for PBC is mainly ursodeoxycholic acid at a dose of 13-15 mg/kg/day, and long-term maintenance treatment is required. In addition, patients with PBC are prone to osteoporosis and should be routinely treated with calcium and vitamin D. Small TIPs for patients with autoimmune liver disease: Is autoimmune liver disease contagious? Autoimmune liver disease is an autoimmune disease, not caused by hepatitis virus infection, so it is not contagious. What should I pay attention to in my diet for autoimmune liver disease patients? Patients with autoimmune liver disease should not eat high-fat foods, such as animal offal and fatty meat; they should not take tonic drugs of unknown composition; they should eat less mushrooms and celery; they should eat high-protein foods such as fish, shrimp, lean meat, fresh fruits and vegetables. Source from 2015-04-22 Luliangjing Wang Suli Rheumatism and immune disease doctor-patient exchange platform (micro signal luliangjing920 ). (The picture in the text is transferred from the network, the above content is the exclusive production of rheumatic immune disease doctor-patient exchange platform, other WeChat public accounts or media if reproduced, please indicate the source or source!)