title: Childhood Autoimmune Hepatitis in Bahrain: a Tertiary Center Experience.
abstract: BACKGROUND
  Autoimmune hepatitis (AIH) in childhood has variable modes of presentation, and the disease should be suspected and excluded in all children presenting with symptoms and signs of prolonged or severe acute liver disease. In AIH, the liver biopsy histopathology shows inflammation in addition to presence of serum autoimmune antibodies and increased levels of immunoglobulin G (IgG).
  
  
  OBJECTIVE
  To investigate the situation of childhood autoimmune hepatitis in Bahrain and to compare it with other studies worldwide.
  
  
  METHODS
  A retrospective study describing the AIH pediatric cases diagnosed during the period of Jan 2005 to Dec 2009. We report the clinical, biochemical, histopathological, and immunological findings, mainly autoimmune profile, in addition to response to treatment, of Bahraini children with autoimmune hepatitis.
  
  
  RESULTS
  Five Bahraini children, three females and two males were diagnosed as autoimmune hepatitis during the study period. Their ages at presentation ranged from 9 to 15 (median 10.6) years. One of our patients had a fulminating type. Two had other autoimmune related conditions, namely autoimmune sclerosing cholangitis and ulcerative colitis. All were AIH type 1. Variable response to conventional immunosuppressive therapy was found, from an excellent response with good prognosis, to cirrhosis, hepatic failure and liver transplantation.
  
  
  CONCLUSIONS
  Childhood AIH is a rare medical problem in Bahrain, with both sexes affected and a variable response to immunosuppressive therapy.
authors.affiliation: Department of Pathology, Salmaniya Medical Complex, Manama-Kingdom, Bahrain, e-mail:efareed@health.gov.bh.
authors.forename: Eman
authors.initials: E
authors.lastname: Farid
authors.forename: Hasan M
authors.initials: HM
authors.lastname: Isa
authors.forename: Mohamed
authors.initials: M
authors.lastname: Al Nasef
authors.forename: Rawia
authors.initials: R
authors.lastname: Mohamed
authors.forename: Huda
authors.initials: H
authors.lastname: Jamsheer
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D001445:Bahrain; D002648:Child; D002675:Child, Preschool; D015209:Cholangitis, Sclerosing / Q000150:complications / Q000276:immunology; D003093:Colitis, Ulcerative / Q000150:complications / Q000276:immunology; D005260:Female; D019693:Hepatitis, Autoimmune / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008099:Liver / Q000276:immunology / Q000473:pathology; D008297:Male; D012189:Retrospective Studies; D062606:Tertiary Care Centers
chemical_list: D001323:Autoantibodies; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents