title: Autoimmune hepatitis in children: progression of 20 cases in northern Mexico.
abstract: BACKGROUND
  Autoimmune hepatitis (AIH) is a chronic inflammatory disease of the liver with nonspecific clinical manifestations that causes greater liver damage in children than in adults.
  
  
  OBJECTIVE
  To analyze the clinical progression, biochemical profiles, histopathologic changes, and treatment response in 20 children with AIH.
  
  
  METHODS
  A retrospective study was carried out on the variables associated with clinical progression, diagnosis, and treatment response in children seen at the the Unidad Médica de Alta Especialidad (UMAE) No. 71 IMSS in Torreón, Coahuila, Mexico, from 1992 to 2012.
  
  
  RESULTS
  Twenty patients were analyzed, 75% with type 1 AIH (AIH-1) and 25% with type 2 AIH (AIH-2). Girls predominated with a 3:1 ratio of girls to boys. The mean age was 10.07 ± 6.53 years for the AIH-1 cases and 6.75 ± 3.77 years for the AIH-2 cases. There was an association with immunologic diseases in 40% of the patients. The patients in the AIH-2 group had greater biochemical profile alterations and IgA deficiency. Anti-nuclear antibody and anti-smooth muscle antibody were positive in 100% of the patients with AIH-1, and anti-liver kidney microsomal type 1 antibody was positive in 100% of the AIH-2 patients. Liver biopsy revealed interface hepatitis in both groups. The AIH-2 group responded more quickly to treatment, but had a higher recurrence rate.
  
  
  CONCLUSIONS
  Autoimmune hepatitis in the pediatric patient should be suspected in order to make an early diagnosis and thereby establish opportune treatment. Determining the type of AIH is necessary for making adequate diagnosis and for achieving a better outcome in relation to recurrence and complication rates.
authors.affiliation: Servicio de Gastroenterología y Nutrición Pediátrica UMAE, Hospital de Especialidades N.° 71, IMSS, Torreón, Coahuila, México. Electronic address: doctornares@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Nares-Cisneros
authors.affiliation: División de Investigación en Salud, Unidad Médica de Alta Especialidad, Hospital de Especialidades N.° 71, IMSS, Torreón, Coahuila, México.
authors.forename: Y
authors.initials: Y
authors.lastname: Jaramillo-Rodríguez
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D019693:Hepatitis, Autoimmune / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008800:Mexico / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome
keywords: Autoimmune hepatitis; Biopsia hepática; Children; Evolución; Hepatitis autoinmune; Liver biopsy; Niños; Progression; Tratamiento; Treatment