At the beginning, autoimmune liver diseases cause no or very little symptoms. Therefore, they often are only diagnosed at a later or even advanced stage. The first symptoms usually are non-specific – they occur in many diseases.
Fatigue and joint pain (arthralgia)
In some patients, the disease starts with a feeling of fatigue and malaise. This unpleasant symptom can have many reasons. Joint pain may also occur as an early sign of an autoimmune liver disease. Usually several joints are affected at the same time. Typically, the joints are not swollen, reddened or warm.
In primary biliary cirrhosis early symptoms may be itching and an uncomfortable dryness of the mouth and the eyes. Increased body temperature or even fever is very rare in these diseases, and if present suggests an additional infection.
Yellowing of the skin and the mucosa (jaundice), typical for liver disease, may occur right at the beginning of an autoimmune hepatitis. Jaundice is a symptom of an acute episode, but may also be a sign of advanced liver disease. In primary sclerosing cholangitis and primary biliary cirrhosis jaundice usually occurs only late in the clinical course of the disease.
Exemption: severe clinical course
In very rare cases, autoimmune hepatitis may take an acute, severe course with a general feeling of illness and marked fatigue. Since in such cases yellowing of the skin is considerable, the liver will be considered as the cause of the condition very soon. The urine will be dark. Acute autoimmune hepatitis is always an emergency and requires immediate medical treatment since otherwise the liver may be damaged permanently. The patient should get medical treatment in a department with expert knowledge in the diagnosis and treatment of autoimmune liver diseases.