Liver Function
The heart is the "engine room" of the body. It plays an important role in digestion, he made hundreds of components (eg, most blood proteins) are essential for life, he is the major site of energy production and worked as a storehouse of energy, and he helped in spending toxic compounds from the blood .
The human heart consists of two main segments or lobes: a large right lobe and smaller left lobe. He held against the diaphragm under the rib cage on the right side of the abdomen. In adults, it weighs about 2-3 lbs (1.0-1.5 kg) and maintains its size at a relatively constant proportion to body weight, increases or decreases in size when we add or lose weight. This represents a huge excess capacity on what is actually needed to sustain life, and we can actually manage quite well with only approximately 20-30% of our hearts that function normally. He is a very powerful organ. When damaged, and if the damage can be stopped, or when partially removed surgically, it is the only organ that has the ability to regenerate itself fully into the exact right size.
The liver helps digestion by producing bile, a liquid is brown-orange that is a mixture of cholesterol, various proteins and are called bile salts - which is a detergent-detergent is very strong. The color is caused by the presence of bilirubin, which is a waste product formed from hemoglobin (the main oxygen-carrying protein in red blood cells) when cells described crimson blood. Bile issued via the bile ducts and is stored in the gallbladder, from which he was expelled into the duodenum (the first part of the intestines) when necessary. Fatty foods entering the duodenum from the stomach is made more digestible by emulsification by bile salts. Bilirubin and product descriptions are the pigments that give color to normal stools their brown. Is also the pigment that makes skin turning yellow in those jaundiced. This is because, when the liver is damaged, bile often can not be removed properly and bilirubin tends to accumulate in the blood.
The definition of Auto-Immune Hepatitis
That is, it is a disease where the body "rejecting" his own heart. Body's immune system is normally designed to fight infection. When we are infected by, say, a virus, cell-specific white blood cells attack the infecting organism and eliminating direct or produce proteins known as antibodies that specifically recognize and help destroy the organism. Quite often, infections accompanied by some (usually fairly minor) damage "that happened" on the tissues of healthy, by white blood cells themselves or through the production of antibodies (known as auto-antibodies) against the tissues own body. The same thing can occur when the tissues damaged by chemical compounds (such as some types of drugs). With other words, we are all in a state of "autoimmunity", but in most people there are mechanisms that turn off (or control) autoimmune reactions by our immune systems against our own tissues. In people with AIH, it seems that they are born with (or developing) defects in this control system so that they can not turn off the autoimmune attack against their own care. Similar defects appear present in people with autoimmune diseases of other organs, such as autoimmune thyroid disease, myasthenia gravis (which affects the nerves and muscles), rheumatoid arthritis (which affects the joints), and some forms of diabetes.
Why only some tissues affected, eg the liver in AIH, and not the others? This is because the control mechanism is very complex. It seems that he has several components, some of which have the effect of "dampening down" the public on the immune system and others that control the reactions separately against each of the different tissues in the body. Fatherly develop an autoimmune disease that affects only (or mainly) a single organ, it is possible that parts of the common controls are not working properly and that there is additional damage on one of the parts that control the reactions to each network separately .
The Different Types of Autoimmune Hepatitis
Until a few years ago, investigators who conduct research on diseases classify AIH according to the different types of auto antibodies are found in the blood of patients. Patients with antinuclear (ANA) or smooth muscle (SMA) auto antibodies, or both, is said to have type 1 AIH and those who do not have it but have so-called liver-kidney microsomal antibodies (LKM1) said the type of disease empunyai 2. Approximately 95% of people with AIH, which covers all the age limit of men and women, have type 1. atients type 2 consists of a small group of (usually) young women with severe disease. Later, recognized that some patients do not have any of these three antibodies, but reserve the other auto antibodies are found. It is classified as having AIH type 3 and other subdivisions-subdivis recommended by other auto-antibodies were found. Experience and further research has shown that the severity of the disease is more linked to the age when he developed (see section four) than on the type of auto antibodies and that, at least from a clinical view, there is little difference between different types or subtypes . All types respond to standard treatment (see section to eight) in most cases and there is not much difference in the long-term outcome. Nevertheless, the terms type 1 and type 2 is still commonly used because it is felt that the mechanisms of liver damage may be different on the two types of these - although the response to treatment and outcomes were similar.
Who's More Influenced, Men Or Women-Women?
Like most autoimmune diseases, it mainly affects women (only approximately 20% of people with AIH are male). He can develop at any age but the great majority of people with AIH develop the disease between the ages between 50 and 70 years (often around menopause in women). He tends to be more severe in people who are younger. People who are older generally have milder forms are often more easily controlled with treatment (see the section he was treated).
How Many Known From This Disease?
Quite a lot actually - at least with regard to the signs and symptoms and how to diagnose and treat. It is known that people with AIH seems to have a genetic predisposition to the disease and that there might be something, like a viral infection of the liver (which may not be detected), which is required to trigger an autoimmune reaction in the first place (which may explain why most people do not has an illness from birth, although they were born with defects). However, the exact nature of the defects, or how to correct them permanently, or what actually caused the liver damage, is still unknown.
Is He Or Rare Diseases Common, Very Rare Disease Found?
He seems quite rare, but we really do not know how common it is. Rough approximations suggest that probably somewhere between 6.000 and 10.000 people are affected in the UK. However, it is now known that many people may have no symptoms for long periods and it is possible that many of who have mild disease may never in diagnosis as having AIH. In some countries where other diseases of the liver (such as chronic viral hepatitis) is very common, these conditions may be hiding AIH and he may not be found.
Types of Problems That Can Go Wrong With This Disease Type
The vast majority of people with AIH respond well to treatment and felt pretty good most of the time. The main issues complained of by some people are feeling a bit tired from time to time. Also, for reasons that are not understood, in some people the illness continues to cirrhosis despite apparently adequate control with treatment. Cirrhosis is a term used to describe the deposition of scar tissue in the liver (whatever the cause). This may present problems of its own, the main one is the increasing pressure on the blood vessels leading to the liver (portal hypertension) which, in turn, may lead to the development of varicose veins (varices) in the stomach and around the lower end of the esophagus , which may be bloody. On the other hand, it is known that people can have cirrhosis for 20 or 30 years without developing problems like that, so they may never arise. Other problems that can develop may be caused by medications used to control the disease, but in most cases is not serious Adala. Approximately 50% of people find that they gain weight when they first start taking steroids. In approximately 20% of this, excessive weight gain causes an increase in blood pressure (which may require treatment). Steroids can also lead to the development of diabetes or osteoporosis (thinning bones) but, again, at low enough doses that are usually required to maintain remission, these complications are relatively rare. Approximately 10% of people can not tolerate azathioprine, because they develop a rash, or stomach-gastric she disturb them, or it affects the white blood cells they are. In these cases, doses slightly higher than steroids may be needed to maintain remission.
How?
AIH is a chronic liver diseases is very little that can be very effectively treated with medication therapy only in the great majority of cases. Corticosteroids (usually prednisone or prednisolone) is the standard treatment. Azathioprine is often also used, because this has the effect of allowing additional doses lower than steroids to be used, but approximately 10% of people can not tolerate azathioprine for a variety of causes. Initially, high doses of steroids are required for several weeks or months to get the disease under control as soon as possible. Subsequently, and especially if azathioprine tolerated, the dose of steroids can often be reduced to levels low enough. Three recent studies (in the U.S., Sweden and Germany) have indicated that, for most people with AIH whose disease well controlled, life expectancy did not differ significantly from the rest of the population. The important thing is to take the tablets exactly as in recipes by a doctor.
Medications Work And How They Help
Two major drugs, corticosteroids and azathioprine, reduce autoimmune reactions. In a sense, they act as the drugs' anti-rejection "and indeed they are also used (among other medications) to prevent rejection after transplantation. The drugs' anti-rejection "of other, newer shows promise for people who do not respond to standard treatments.
I Will Release Of Medications? Why?
This will depend partly on how severe your disease substantially and how well (how quickly) it responds to treatment. As noted above, the vast majority of people respond quickly enough and they began to control the disease within a few months on treatment, but it seems to take at least a year, sometimes several years, to get it under control completely (meaning fully entered remission). After that, it is possible to stop treatment, but the available evidence indicates that only approximately 20-30% of people can remain free of drugs for long periods. There is always the possibility that the disease may return (relapse), even years after stopping treatment. However, if he returns, he can usually be controlled with standard care anymore.
What Can I And Can not Do If I Have AIH
If your disease well controlled on treatment, there is actually little that you can not do. However, you should generally avoid alcohol. One glass of wine or half pint of beer at special events may not harm you, but this should really "sometimes" (meaning no more than once per month). On the other hand, if AIH you are not fully controlled, you can do anything you want to do but you should avoid alcohol completely. Your doctor is the best person to advise you on this.
Will Transplantation Necessary?
This will depend on whether your disease responds quite satisfactorily to treatment. As mentioned above, the vast majority of people with AIH respond well and therefore did not require transplantation. A small number of people who may need a transplant are those with severe disease who do not respond quickly enough on treatment and some of that with a prolonged illness that has continued to the point where not enough heart left to defend life or who have developed complication- serious complications.
Figures Survival Of Transplant
Because of improvements in operating improvement (and the drugs used to prevent rejection) over the last 5-10 years, the survival figures are usually taken into account for only 5 years (since the doctors still do not have enough experience with the development These new developments through periods longer). Also, because so few people with AIH who require liver transplants, the experience is still quite limited. The good news is that, between the centers of the world where most liver transplants for AIH is done, now 5-year survival is approximately 80-90%.
If the transplant is needed, Will Return illness?
Unfortunately, yes he can return. However, the drugs used to prevent rejection can also help control the AIH and usually only when these drugs are reduced to low doses or discontinued with the disease again. However, if he returns, he can often be controlled with standard therapy again.
Why go back?
Probably because the transplant does not cure the basic genetic defects associated with the control of autoimmune reactions.
Opportunities Return of Disease
This is really unknown, because the numbers of people with AIH who need transplants are so small and still no adequate long-term experience to make these calculations.
What Happens After Transplant, What Next?
It depends on how well the transplant goes. However, most people who are transplanted for AIH is running well and running nearly normal lives - even on a range of sometimes competing in the Transplant Olympics!
Medications Required To Stop Rejection
Previously, the main drugs used are steroids, azathioprine and cyclosporine, in various combinations. However, in the years recently tacrolimus are being increasingly used to great effect and other drugs, newer such as mycophenolate also gives promising results.
If I Have AIH, Can I Have Children?
If you are a male, should be no problem. If you are a woman, it would depend on how well you controlled the disease and complications of what (if any) which has been developed by you. Your doctor is the best person to advise you on this. If your disease is active, you may find that you can not become pregnant because of active disease that can affect ovulation. Studies recently have shown that women younger with AIH whose disease in remission often enough to become pregnant. Most do not have major problems during their pregnancies and have healthy babies are normal. However, for reasons that are not understood, some women relapse (relapse) during their pregnancies and others relapse within a few months after birth, even if they had continued throughout their normal drug treatment. Therefore, it is important to have check-ups are very regularly during pregnancy and after birth, and to recognize that an increase in your medication may be necessary at some stage. The available evidence suggests that, at doses normally used to maintain AIH in remission, steroids and azathioprine do not seem to affect the baby.
Can AIH Inherited?
Everything about our bodies is controlled by our genes, which we inherited from the parents, our parents and ancestors, their ancestors. But the functions of our genes can be influenced by external factors and changes throughout life - which is why we do not enjoy the "eternal youth". Furthermore, we all have defects of one kind or another in our genes. Whether these defects affect our lives depend on what they are. In many incidents the damage is not important or are there other genes that can compensate them. As discussed above, it seems likely that some defects in the control of the immune system is required for developing AIH, and that it is genetic in nature and may be inherited. So, it seems is a genetic predisposition to the development of AIH. However, AIH is not hereditary in the usual sense. It seems he is more "accidents of nature", where a number of different genes that tend to have the disease come together on a single individual. There are very few reports of AIH occurring in more than one family member, so now this knowledge suggests that it is highly unlikely that it can be lowered to one child.
Definition of Liver Biopsy
This is a diagnostic procedure used to obtain small amounts of liver tissue, which can be examined under the microscope to help identify the cause or stage of liver disease.
Dangers Of Liver Biopsy
Bleeding is a major risk of liver biopsy, from the side where the needle into the liver, although this occurs in less than 1% of patients. Fortunately, the risk of death from liver biopsy is very low, cover from 0.1% to 0.01%.
Definis Cirrhosis
Liver has a remarkable capacity to repair themselves when damaged. But when the cause of the damage persists, however, as in chronic hepatitis, the process of repair may not be able to be in line with the continuous cell death. As a consequence, reticulin framework in place that holds hepatocytes collapse on itself and eventually begin to stick together, forming scar tissue. This process is known as fibrosis. If fibrosisnya severe, the tissue that is formed can begin to interfere with the roads that cross the normal blood through the liver. Some liver cells may then be starved of oxygen and nutrients, and this can lead to further cell death and formation of more scar tissue - a kind of process that perpetuates itself that can be developed in common with anything that causes damage to the place first. When fibrosis becomes severe, he was known as cirrhosis - a term derived from the Greek word kirros, which means orange or Tawny, which really describes the appearance of liver cirrhosis caused by a reduction in the amount of blood flowing through it and the accumulation of pigments bile in it.
What causes Cirrhosis
Often it is estimated that cirrhosis caused by excessive alcohol consumption. This is not true. In fact, cirrhosis can be caused by any process that continuously damage the liver. Although heavy drinking is a major cause in Europe or North America, is responsible for only about 60% of cases of cirrhosis in these countries. In areas of the world where viral hepatitis and various other microbe infections of the liver is very common, the vast majority of cases of cirrhosis caused by chronic infections with these agents. Other important causes include autoimmune liver diseases and a variety of genetic diseases that affect the liver.
Cirrhosis Can Cured?
Once cirrhosis is essentially upheld the process can not be reversed. Healing is the only one liver transplant, but this may not always be possible or appropriate. However, the severity can often be reduced by removing or treating the underlying cause of cirrhosis. For example, individuals with cirrhosis caused by excessive alcohol consumption often experienced a dramatic improvement when they stop drinking alcohol.
Is there Treatment for Cirrhosis?
There is no treatment for cirrhosis itself, but complications arise in advanced stages can often be treated successfully, with the prolongation of life that can be considered. If portal hypertension develops, it is sometimes possible to treat with medications to reduce blood pressure. Other drugs, known as diuretics, often used to reduce fluid accumulation in patients with ascites or other forms of edema. If this does not work, surgery may be needed to reduce the ascites or liver transplantation may be needed. Gastric varices or esophageal can be injected with a compound known as a sclerosant to close this road and stop the bleeding. This is similar to the treatment of varicose veins on the legs, but this must be done by endoscopy. Development of a more recently involves the use of the endoscope to place small rubber bands around varices to end the local blood supply.
If there is severe bleeding, which can be inflated baloon may be lowered into the esophagus to apply the pressure as an emergency measure to stop bleeding to endoscopic injection or varices can be performed. In some cases, may need to consider surgery, known as a shunt procedure (or TIPS), to divert blood from the portal vein into other vessels that can handle pressure.
Symptoms
* Fatigue - symptoms-the most common are those with AIH will be facing.
* Liver is enlarged.
* Jaundice.
* Itching.
* Skin rash.
* Joint pain.
* Stomach discomfort.
* Fluid in the abdomen (ascites).
* Mental confusion.
* Amenorrhea.
People in advanced stages of disease likely to have symptoms such as fluid in the abdomen (ascites) or mental confusion. Women may stop having menstrual periods. Symptoms of autoimmune hepatitis range from mild to severe. Because severe viral hepatitis or hepatitis caused by drugs - for example, certain antibiotics - has the same symptoms, tests may be needed for proper diagnosis. Your doctor should also review and rule out all of your medicine before diagnosing autoimmune hepatitis.
