Clinical and biochemical features of autoimmune hepatitis in 36 pediatric patients.
BACKGROUND
Few studies on autoimmune hepatitis have enrolled non-Caucasian groups.


OBJECTIVE
To evaluate Brazilian children with type 1 and 2 autoimmune hepatitis regarding outcome and clinical and biochemical parameters.


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.
Bellomo-Brandão
Maria Angela
MA
Department of Pediatrics, School of Medical Sciences, State University of Campinas, SP, Brazil.
Costa-Pinto
Elizete Aparecida Lomazi da
EA
De Tommaso
Adriana Maria Alves
AM
Hessel
Gabriel
G
D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001379:Azathioprine / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D019693:Hepatitis, Autoimmune / Q000201:enzymology / Q000208:ethnology / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D016031:Liver Transplantation; D008297:Male; D011241:Prednisone / Q000627:therapeutic use; D005723:gamma-Glutamyltransferase / Q000097:blood
D015415:Biomarkers; D007166:Immunosuppressive Agents; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001379:Azathioprine; D011241:Prednisone