Autoimmune diseases occur when the immune system cannot distinguish between foreign cells and normal body cells, causing the body to attack its own normal cells.

Autoimmune diseases are not contagious, but are chronic, and can attack various organs, one of which is the liver with the name Autoimmune Hepatitis.

Symptoms caused by autoimmune diseases vary, ranging from mild to severe. This is influenced by various factors, such as: genetics, environment and health conditions of each individual.

To diagnose autoimmune hepatitis, it is necessary to examine the patient's medical history, such as whether there is a history of certain medications being taken, the habit of drinking alcohol and having certain autoimmune conditions. Then the patient will undergo a physical examination to follow up if there are signs of hepatitis. Patients are also asked to undergo a series of supporting examinations, both laboratory and electromedical tests.

Examinations that are recommended to confirm the diagnosis in patients with indications of Hepatitis are:

• Liver Function Tests

• Hepatitis Serology Test

• Liver biopsy to determine the cause of liver tissue damage

• Ultrasound of the Stomach/Abdomen

Laboratory tests for hepatitis include:

1. Hepatitis A, advice examination: anti HAV IgM.

2. Hepatitis B, examination suggestions: panel examination of liver function tests (SGPT and SGOT), HBsAg serology, Anti HBs, IgM Anti HBc, Anti HBc. In chronic Hepatitis B, positive HbsAg (Hepatitis B surface antigen ) > 6 months, other tests such as HBeAg (Hepatitis B E-Antigen), Anti HBe serum, ALT (Alanine Amino Transferase), HBV-DNA (Hepatitis B virus – Deoxyribunucleic Acid ) PCR.

3. Hepatitis C, the diagnosis is made by examining Anti HCV & HCV RNA PCR.

4. Hepatitis D, advice on examination: Anti HDV & IgM Anti HDV.

5. Hepatitis E, examination suggestions: IgM anti HEV and IgG anti HEV.

Regarding the diagnosis of autoimmune diseases, usually the doctor will combine several tests, general or specific, based on history of complaints, symptoms and results of previous physical examinations.

The choice of the type of examination for each patient will be different according to his medical history.

General laboratory tests such as complete hematology and C-reactive protein (CRP) are needed to detect inflammation in a person's body.

One type of specific inspection that needs to be done is:

ANA test (Antinuclear Antibody Test). A positive ANA test indicates that a person has a type of autoimmune disease, but the specific type of disease cannot be identified.

Other laboratory tests such as:

• Antistreptolysin Test (ASTO) is performed if there is a suspicion of a disease caused by a group A Streptococcus bacterial infection

• ANTI-ds DNA to assist diagnosis in patients with a positive ANA test and have symptoms and complaints related to SLE (Systemic Lupus Erythematosus).

• Rheumatoid Factor can be done if there is suspicion of Rheumatoid Arthritis.

Author: dr. Elly Widiatmaningrum (Consultant Medical Doctor for PRAMITA Clinical Laboratory Jl. D.I. Panjaitan No. 7-7A, Semarang)