title: [Type 1 autoimmune hepatitis in children and adolescents: assessment of immunosuppressive treatment withdrawal].
abstract: OBJECTIVE
  To assess treatment withdrawal in children and adolescents with autoimmune hepatitis, with clinical and laboratory remission for a minimum period of 24 months, determining the relapse rate after treatment withdrawal.
  
  
  METHODS
  This is a descriptive, retrospective and partially prospective study of 21 children and adolescents with type 1 autoimmune hepatitis treated at the Outpatient Division of Pediatric Hepatology, Teaching Hospital of Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil, between January 1986 and December 2001.
  
  
  RESULTS
  We assessed 54 patients and selected 21, of whom 19 were female subjects (90.5%), aged between 5.7 and 17.6 years (median = 13.8 years), with a mean follow-up of 5.1+/-2.4 years (median = 4.4 years) and an average clinical and laboratory remission of 4.1+/-1.5 years (median = 4.1 years). Out of the 21 patients studied, 10 (47.6%) manifested some inflammatory activity that prevented the discontinuation of treatment, which was withdrawn in 11 patients (52.4%). Out of these, six patients (54.5%) presented reactivation of the disease and five maintained clinical and laboratory remission with a mean follow-up of 4+/-1 years (median = 3.9 years). The time interval between discontinuation of treatment and reactivation of the disease ranged from 29 days to 40.3 months (median = 2.2 months).
  
  
  CONCLUSIONS
  We observed a high relapse rate (54.5%) in this group of patients with autoimmune hepatitis, which was more frequent within the first 12 months after treatment withdrawal, in addition to a high number of patients that presented some degree of inflammatory activity despite the long period of clinical and laboratory remission.
authors.affiliation: Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil. alexfer@uai.com.br
authors.forename: Alexandre R
authors.initials: AR
authors.lastname: Ferreira
authors.forename: Mariza Leitão Valadares
authors.initials: ML
authors.lastname: Roquete
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Penna
authors.forename: Nivaldo H
authors.initials: NH
authors.lastname: Toppa
authors.forename: Lúcia Porto Fonseca de
authors.initials: LP
authors.lastname: Castro
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D019693:Hepatitis, Autoimmune / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007223:Infant; D008099:Liver / Q000473:pathology*; D008297:Male; D012008:Recurrence; D012074:Remission Induction; D013997:Time Factors; D028761:Withholding Treatment
chemical_list: D007166:Immunosuppressive Agents