Chronic cryptogenic hepatitis in childhood is unrelated to hepatitis G virus.
OBJECTIVE
The aim of this study was to define the features of chronic cryptogenic hepatitis (CCH) in childhood and to investigate whether it is related to hepatitis G virus infection.


METHODS
Forty-six children (24 males; age range, 1.5 to 17 years) with CCH were studied. CCH was diagnosed when serum alanine aminotransferase concentrations were more than 1.5 times normal for longer than 6 months without any apparent cause of liver disease.


RESULTS
No patient had acute symptomatic onset or had received a blood transfusion. Three had undergone minor surgical procedures. All appeared to be healthy during follow-up (median, 4.2 years; range, 1 to 10 years). Hypertransaminasemia was the only aberrant liver function test. Elevated serum alanine aminotransferase values alternated with normal values in 40 children (86.9%). Five children (10.8%) had a spontaneous sustained (>12 months) remission of hypertransaminasemia. Twelve (26%) had laboratory signs of autoimmunity, but none fulfilled the criteria for autoimmune hepatitis. Of 20 children who underwent liver biopsy, 13 (65%) had minimal chronic hepatitis, 4 (20%) had mild chronic hepatitis and 3 (15%) had moderate chronic hepatitis. Serum hepatitis G virus RNA was detected in 2 girls (4%) whose risk factor was a hepatitis G virus-infected mother and a minor surgical procedure, respectively. In 12 families at least 1 other member had chronic liver disease.


CONCLUSIONS
Childhood CCH seems to be a symptomless disease characterized by isolated hypertransaminasemia with onset during the first 4 years of life and mild to moderate histologic liver lesions. Although the frequency of spontaneous remissions is low, childhood CCH seems, in the short run, to be a nonprogressive disease. Hepatitis G virus does not play a major role in CCH.
Iorio
R
R
Department of Pediatrics, University of Naples Federico II, Italy. riorio@unina.it
Pensati
P
P
Botta
S
S
Vajro
P
P
Sepe
A
A
Donetto
S
S
Vecchione
R
R
Artini
M
M
Levrero
M
M
Vegnente
A
A
D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D018450:Disease Progression; D005260:Female; D018067:Flaviviridae / Q000302:isolation & purification; D006521:Hepatitis, Chronic / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D006525:Hepatitis, Viral, Human / Q000175:diagnosis; D006801:Humans; D007223:Infant; D008111:Liver Function Tests; D008297:Male; D010375:Pedigree; D012075:Remission, Spontaneous
D000410:Alanine Transaminase