Prednisone is needed for both your Glaucoma and RA. And fortunately, it is used to treat AIH as well, but usually in combination: prednisone and
Azathioprine, etc - for example. I would think that staying with your current
treatment plan is a safe route, for now. At least until something new can be
developed that will comprehend all of the diseases involved.
Your biopsy supports the AIH diagnosis, as noted. But you also indicated some bile ductular proliferation in a previous message. And certainly the stage-3, bridging fibrosis can cause compression of the existing biliary canaliculi/ductules, and this can cause the biliary reaction that were noted. But, if it is focused around the portal tracts, and also included portal expansion combined with edema, this maybe an indication that you also are dealing with an additional biliary issue. Additionally, the fibrotic pattern is a hint as to what is really going on, wrt the attack on your liver. If the fibrosis is strictly portal-to-portal vs central-to-central, etc - this will help your doctors understand the form of attack that your liver is undergoing.
AIH can overlap biliary diseases, PBC and PSC, so it is something that your doctors will be watching for. Given this possibility, your elevated ALP is something they will watch, since the levels are a bit higher than typical for AIH. But always remember. liver diseases are very, very complicated, and we here are not doctors.
With additional blood serum data, we can help you assess your liver's actual condition. The liver enzymes only indicate what's happening with your liver
within the past few days. They do not tell you how healthy your liver really is. Your liver does many things and includes many synthesis and excretory functions. The doctors will use something called the MELD score to quantify this. If you can give us your blood levels for a handful of items, specifically: INR, Creatinine and Bilirubin - we can help your assess your liver's health. Also of interest are the Albumin and Globulin levels, Platelets, Spleen size and RBC/WBC counts - again our livers are very complicated organs.
You don't need to worry about the disease moving too fast. Now that your doctors are on board, and have the data they need, you should quickly become "stable".If it also proves that you are in an advanced liver disease state, then you will need to have a good hepatologist, at one of the major liver transplant centers. This does not mean that you will need a liver transplant! But these are the best liver doctors out there, and you want to have them on your team. But a proper treatment plan needs to be applied and rigorously followed.
There is an additional Medhelp Community to tap into, Liver Disorders. Take care and please keep in touch with us. Btw, I have a sister disease of sorts: PSC, Primary Sclerosing Cholangitis - it is an autoimmune disease, like AIH.
Your numbers are very good. The A/G ratio is a bit low but this can be due to many things. Your liver seems to be very healthy! So you shouldn't worry too much, your doctors will get you stable.
As far as fatigue goes, it comes with many autoimmune diseases. My autoantibodies are very elevated and my fatigue is debilitating most days. But you learn to pick your battles and work through things. Keep up the exercise, do what you can but don't push too much.