Egyptian Pediatric Association Gazette (Nov 2017)
Characteristics of autoimmune hepatitis in a sample of Egyptian children
Abstract
Background: Autoimmune hepatitis is a rare liver disease that can be presented aggressively in children. Early treatment can control the hyper immune state and save the liver. The aim of the work: To assess clinical manifestations, biochemical features, and response to immunosuppressive drugs in children with AIH. Methods: 25 children with AIH, based on the International Scoring Criteria of Autoimmune Hepatitis (IAIHG score system), recruited from Pediatric Hepatology clinic, Benha University Hospitals have been analyzed for their clinical, biochemical features, histological profile and their response to treatment. Results: 25 children were 15 female (60%) and 10 male (40%) their ages ranged from 3 to 15 years old. The main clinical presentation were jaundice (68.0%), abdominal pain (48.0%), acute hepatic-like illness was the first presentation in (32.0%), hepatomegaly (80.0%), splenomegaly (40.0%) lower limb edema (12.0%), and ascites (12.0%). All patients at first presentations had high serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and serum immunoglobulin G (IgG). According to the autoantibody profile, all children were classified as AIH type 1 as no patient was seropositive for anti-liver kidney microsome antibody (anti-LKM). Prednisone with or without azathioprine was started and complete remission noticed in 13 (52.0%) while 12 (48.0%) had relapses. Conclusion: AIH type 1 was the main type of autoimmune hepatitis in children referred to Benha University Hospitals. Females more affected than boys. The combination of prednisone and azathioprine are effective in abating the inflammatory process in most of the cases. Early diagnosis and treatment of AIH had apparently good outcome in children.
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