ABSTRACT
Autoimmune hepatitis [AIH] in children is a rare chronic progressive liver disorder. It is characterized serologically by high aminotransferase levels, elevated immunoglobulin G [JgG] and the presence of autoantibodies. AIH is divided into two types according to the auto antibody profile. This study aims to assess frequency, clinical manifestations, biochemical features and outcome of AIH in children attending Assuit University Hospitals with acute icteric hepatitis and sero-negative viral markers [anti-HAV JgM, Hbs Ag, anti- HCV AB]
Patients and methods: 34 children with AIH, based on the International Scoring Criteria of Autoimmune Hepatitis, recruited from Assuit University Hospitals, during the period from January 2005 to December 2009. Alf patients received prednisolone 2 mg/kg per day. Follow-up was done for one year
Results: among 34 children diagnosed as AIH, 24 were females [70.5%] with a mean age of 8.7 +/- 3.4 years and JO were males [29.5%] with a mean age of 9.5 +/- 2.8 years at time of presentation. Jaundice represented the most consistent finding in all patients. According to the auto antibody profile, 25 children were classified as type 1 and 9 children were classified as type 2. Corticosteroid therapy was started. Complete remission was observed in 67.6% of patients and partial remission in I 7. 6%. There was no significant statistical difference in clinical and biochemical features of AIH in patients regarding the response to treatment. Mild side effects of the steroid therapy were encountered in 48.2% of patients and disappeared after stoppage of therapy. After complete withdrawal of corticosteroids, 6 patients [20. 7%] developed relapse of the disease
In conclusion: AIH type 1 was the main form of autoimmune hepatitis in children referred to Assiut University Hospitals. Girls more affected than boys. AIH type 1 exhibited a more active ongoing immunologic process. Steroid alone can be used successfully in most cases. Children with AIH type 2 had a higher frequency of relapse after corticosteroid withdrawal. Further studies on bigger number of cases and long-term follow up are recommended
ABSTRACT
Auto-immune hepatitis [AIH] in children is a rare chronic progressive liver disorder. It is characterized serologically by high aminotransferase levels, elevated immunoglobulin G [IgG] and the presence of autoantibodies. AIH is divided into two types according to the autoantibody profile. This study aims to assess frequency, clinical manifestations, biochemical features and outcome of AIH in children attending Assuit University Hospitals in Upper Egypt with acute icteric hepatitis and seronegative viral markers [anti-hepatitis A virus [HAV] IgM, HbsAg, anti-hepatitis C virus [anti-HCV] Ab]. The study includes 34 children with AIH, diagnosed on the basis of the International Scoring Criteria of Auto-immune Hepatitis, recruited from Assuit University Hospitals, during the period from January 2005 to December 2009. All patients received prednisolone 2 mg kg[-1] day[-1]. Follow-up was done for 1 year. Among 34 children diagnosed as AIH, 24 were females [70.5%] and 10 were males [29.5%]. Jaundice represented the most consistent finding in all patients. According to the autoantibody profile, 25 children were classified as type 1 and nine children were classified as type 2. Corticosteroid therapy was started. Complete remission was observed in 67.6% of patients and partial remission in 17.6%. There was no significant statistical difference in clinical and biochemical features of AIH in patients regarding the response to treatment. Mild side effects of steroid therapy were encountered in 48.2% of patients. After complete withdrawal of corticosteroids, six patients [20.7%] developed relapse. AIH type 1 was the main form of AIH in children referred to Assiut University Hospitals. Girls were more affected than boys. AIH type 1 exhibited a more active, ongoing immunologic process. Steroid alone can be used successfully in most cases. Children with AIH type 2 had a higher frequency of relapse after corticosteroid withdrawal. Further studies on a larger number of cases and long-term follow-up are recommended