Autoimmune Hepatitis, PBC, and PSC
Some liver diseases happen when the immune system mistakenly attacks the liver or bile ducts. Found early, most can be controlled with treatment.
Autoimmune hepatitis
The immune system attacks liver cells, causing inflammation. It can appear at any age and is more common in women. Some people have no symptoms; others have tiredness, joint pain, jaundice, or sudden liver inflammation. Diagnosis uses blood tests (liver enzymes, antibodies, and IgG levels) and often a liver biopsy. Treatment usually starts with steroids such as prednisone or budesonide, followed by a steroid-sparing medicine such as azathioprine. Many people need long-term treatment.
Primary biliary cholangitis (PBC)
PBC slowly damages the small bile ducts inside the liver. It is most common in women over 40. Itching and tiredness are typical symptoms, and a high alkaline phosphatase on blood work is often the first clue. A blood test for antimitochondrial antibodies usually confirms it. Ursodiol is the first-line treatment and slows the disease. For people who don't respond fully, newer medicines are available.
Primary sclerosing cholangitis (PSC)
PSC causes inflammation and scarring of the bile ducts inside and outside the liver. It is often linked to ulcerative colitis. It is diagnosed with an MRI of the bile ducts (MRCP). There is no proven medicine yet, so care focuses on monitoring, treating narrowed ducts with ERCP, cancer surveillance, and yearly colonoscopy when IBD is present.
Monitoring
For all of these conditions, we track liver tests and scarring over time, including with liver elastography (FibroScan), and screen for complications such as bone thinning. See also abnormal liver tests.
Make an appointment
Our gastroenterologists in Temple City care for patients from Arcadia, San Gabriel, Pasadena, Monrovia, Monterey Park, and across the San Gabriel Valley. We accept most PPO plans (see accepted insurances), and our doctors speak English, Vietnamese, and Mandarin. Schedule an appointment or call 626-898-4560.
This article is for general education and is not a substitute for medical advice. Talk with your doctor about your own health.
Quick Answers
What is autoimmune hepatitis?
A condition in which the immune system attacks liver cells. It is usually treated with steroids and other medicines that calm the immune system.
What is PBC?
Primary biliary cholangitis is a slowly progressive disease of the small bile ducts, most common in middle-aged women. Ursodiol is the first treatment, and newer medicines are available if it doesn't work well enough.
Is PSC related to ulcerative colitis?
Yes. Many people with primary sclerosing cholangitis also have inflammatory bowel disease, usually ulcerative colitis, so they need regular colonoscopies.
