Advances in the diagnosis and treatment of pediatric autoimmune hepatitis / 临床肝胆病杂志

ABSTRACT

Autoimmune hepatitis (AIH) is a progressive inflammatory liver disease, and the incidence rate of pediatric AIH is gradually increasing in recent years. AIH can be classified into AIH-1 (with positive antinuclear antibody and/or smooth muscle antibody and/or anti-soluble liver antigen antibody) and AIH-2 (with positive liver-kidney microsomal type 1 antibody and/or anti-liver cytosol type 1 antibody), among which AIH-2 is mainly seen in children. Positive autoantibodies are rare in healthy children, and thus the requirements for autoantibody titer in the diagnosis of pediatric AIH are lower than the criteria for adults. Pediatric AIH progresses more rapidly than adult AIH, and treatment should be started immediately after confirmed diagnosis. Scoring systems for the diagnosis of AIH in adults are not applicable to pediatric patients and cannot be used to differentiate AIH from autoimmune sclerosing cholangitis.