Characteristics and outcome of autoimmune liver disease in Asian children

Abstract

Although remission was achieved in the majority of patients with prednisolone and/or azathioprine therapy, delay in seeking diagnosis and treatment adversely affects the outcome of childhood AILD in Malaysia.

Racial disparities in presentation and outcomes of paediatric autoimmune hepatitis

“…Based on the data available, the prevalence of AIH among Caucasians in Europe and North America ranges from 0.1 to 1.9 per 100 000 per year . Most of these studies are predominantly from Caucasian cohorts; and although there are some adult studies reporting that clinical phenotype and outcome may vary by race, the focus of those studies has been the study of Hispanic and Asians cohorts, with exclusion of African American (AA) patients due to inadequate data . A single adult retrospective study of AIH patients did show that AIH was more aggressive in AA male patients, but this study excluded children under the age of 18 .…”

“…3,5,6 Most of these studies are predominantly from Caucasian cohorts; and although there are some adult studies reporting that clinical phenotype and outcome may vary by race, the focus of those studies has been the study of Hispanic and Asians cohorts, with exclusion of African American (AA) patients due to inadequate data. [7][8][9] A single adult retrospective study of AIH patients did show that AIH was more aggressive in AA male patients, but this study excluded children under the age of 18. 10 Current knowledge about clinical presentation, outcomes and management of paediatric AIH are also based on studies from small non-transplant centres and from centres that have a predominantly Caucasian population.…”

Contemporary Methods of Treating Children with Autoimmune Nephric Diseases

“…При поддерживающей терапии преднизолон эффективнее применять ежедневно, поскольку частота возникновения рецидивов на альтернирующей терапии выше [4]. Существуют разные точки зрения по поводу времени назначения азатиоприна: в некоторых центрах азатиоприн добавляют только в случаях, если активность аминотрансфераз перестает убывать на монотерапии преднизолоном, или возникают серьезные стероидные побочные эффекты [1,19]; в других азатиоприн назначают после нескольких недель лечения ГК, когда активность аминотрансфераз в сыворотке начинает снижаться [20]; некоторые используют азатиоприн с самого начала, в дополнение к ГК [5,15]. Вне зависимости от выбранного протокола 85% пациентов в конечном итоге получают комбинированное лечение [21].…”

Autoimmune liver disease in Asian children

“…In the current issue of Hepatology International, Lee et al [10] describe their experience on juvenile autoimmune liver disease in Malaysia. They report retrospectively 32 children of Malaysian, Chinese, Indian and Sabahan background referred to two pediatric centres, 18 with AIH-1, 5 with AIH-2 and 9 with ASC.…”

“…The patients described by Lee et al [10] have laboratory findings similar to those described in Caucasoid patients, a lower prevalence of family history of autoimmune disease (14 versus 40 %), a similar *20 % association with autoimmune disorders-though among the Asian children there was a higher prevalence of systemic lupus erythematosus and a lower prevalence of inflammatory bowel disease, which, however, was investigated only when symptomatic and not routinely like in the UK prospective study [3]. In contrast to reports in Caucasoid patients, the Malaysian children appear to have a much worse prognosis, probably, as stated by the authors, because of the delay between first symptoms and starting treatment.…”