Clinico-laboratory study on children with auto-immune hepatitis in Upper Egypt |
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Authors: | Nagla H. Abu Faddan Laila Abdel-Baky Sherin A. Aly Hebat-allah G. Rashed |
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Affiliation: | 1. Department of Pediatrics, Faculty of Medicine, Assuit University, Assuit, Egypt;2. Department of Tropical Medicine, Faculty of Medicine, Assuit University, Assuit, Egypt;3. Department of Microbiology, Faculty of Medicine, Assuit University, Assuit, Egypt;4. Department of Clinical Pathology, Faculty of Medicine, Assuit University, Assuit, Egypt;1. Gastroenterology and Hepatology Section, DIBIMIS, University of Palermo, Italy;2. Endoscopic Unit, Ospedali Riuniti Villa Sofia-Cervello Palermo, Italy;3. Gastroenterology and Endoscopy Unit, Fondazione Istituto San Raffaele Giglio, Cefalù, Italy;4. Pathology Unit, Ospedali Riuniti Villa Sofia-Cervello Palermo, Italy;5. Internal Medicine Section, DIBIMIS, University of Palermo, Italy;1. Area de Hematología, Hospital Italiano de La Plata, La Plata, Argentina;2. Laboratorio de Genética Hematológica, Instituto de Medicina Experimental, Consejo Nacional de Investigaciones Científicas y Técnicas/Academia Nacional de Medicina, Buenos Aires City, Argentina;3. Servicio de Hematología, Hospital General de Agudos C Durand, Buenos Aires City, Argentina;4. Servicio de Hematología, Hospital Italiano de Buenos Aires, Buenos Aires City, Argentina;5. Servicio de Hematología, Hospital Nacional A Posadas, El Palomar, Argentina;6. Servicio de Hematología, Hospital Universitario Austral, Pilar Centro, Argentina |
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Abstract: | Background and study aimsAuto-immune hepatitis (AIH) in children is a rare chronic progressive liver disorder. It is characterised 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).Patients and methodsThe 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.ResultsAmong 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.ConclusionAIH 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. |
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