Clinical and biochemical features of autoimmune hepatitis in 36 pediatric patients

Abstract

-Background -Few studies on autoimmune hepatitis have enrolled non-Caucasian groups. Aims -To evaluate Brazilian children with type 1 and 2 autoimmune hepatitis regarding outcome and clinical and biochemical parameters.Patients and Methods -Thirty-six patients were submitted to a protocol that evaluated the clinical history, physical and biochemical data, and the course of the disease. Twenty-four children had type 1 autoimmune hepatitis, seven had type 2 and five had unclassified autoimmune hepatitis. Most patients were females (77%), with a median age at diagnosis of 11 years, and the median duration of symptoms was 5.5 and 8 months for types 1 and 2, respectively. Jaundice and choluria were the most common clinical manifestations. Results -Treatment with azathioprine and prednisone was successful in patients with type 1 and 2 autoimmune hepatitis. AST and ALT decreased after 4 to 8 weeks of treatment compared to pretreatment levels in type 1 autoimmune hepatitis. Increased GGT values returned to pretreatment levels after 1 year in the two types. Three patients died and three other patients underwent liver transplantation. Conclusions -Non-Caucasian children had a similar disease when compared to Caucasian ones with autoimmune hepatitis. Increased levels of GGT during the first year of treatment should not be the only parameter for the indication of cholangiopathy.

Research on zinc blood levels and nutritional status in adolescents with autoimmune hepatitis

“…However, Porta (17) did not find weight or height differences in children with AIH and Bellomo-Brandão et al (1) did not observe low stature in patients with type 1 and type 2 AIH. The present study agrees with the two last cited researches, since only two patients presented an H/A z-score below -2, being then classified as bearers of chronic malnutrition with growth delay.…”

“…In the pediatric age group, patients are going through a phase of weight gain, growth and bone formation. However, there are few researches about these parameters in such patients without a study about the specific nutritional deficiencies, such as oligoelements like zinc (Zn) (1,4) . Zn is an essential mineral that is active in several body functions, once it acts as a cofactor for more than 300 enzymes and proteins.…”

Otoimmün hepatitli olgularımızın irdelenmesi: 11 yıllık deneyimimiz

“…80% of autoimmune hepatitis is type 1, 4% is type 2 and 3% is type 3 which is a rare type (2,3,5,8). The type in which autoantibodies can not be identified, but clinical and histological examination are compatible with AIH is called undefined AIH (11). Autoimmune hepatitis is observed more frequently in girls compared to boys (57-93%) and occurs most commonly at the ages of 10-20 years (mean 10 years of age) (11,(17)(18)(19).…”

“…The type in which autoantibodies can not be identified, but clinical and histological examination are compatible with AIH is called undefined AIH (11). Autoimmune hepatitis is observed more frequently in girls compared to boys (57-93%) and occurs most commonly at the ages of 10-20 years (mean 10 years of age) (11,(17)(18)(19). We found female subjects with a rate of 64.5% and the mean age to be 12 years.…”

“…It is characterised by the presence of various autoantibodies in the serum, high level of gammaglobulin and mononuclear cell infiltration in the periportal or portal area histopathologically (motheaten necrosis) (1)(2)(3)(4)(5). According to immunoserologic findings four types of AIH were defined as type 1, type 2, type 3 and undefined autoimmune hepatitis (6)(7)(8)(9)(10)(11). Autoimmune hepatitis occurs mostly at the ages of 10-20 years.…”