title: Autoimmune hepatitis and long-term disease course in children in Turkey, a single-center experience.
abstract: BACKGROUND
  The aim of this study is to determine clinic and laboratory features, treatment protocols, treatment responses, and long term follow-up of children with autoimmune hepatitis (AIH) in a region of Turkey followed at Ege University.
  
  
  METHODS
  The records of 47 children with AIH between 1998 and 2012 were retrospectively analyzed for clinical profiles, treatment response, relapse rate, and long-term side effects.
  
  
  RESULTS
  The median age of the children was 10±4.1 years (55.3% females). A total of 29 patients presented with chronic hepatitis (61.7%). According to the autoantibody profiles, 40 (85.1%) and seven (14.9%) cases were classified as type 1 and type 2, respectively. Presentation with acute hepatitis and chronic hepatitis was significantly higher in type 1 disease. Laboratory findings at presentation was found similar among races as well as AIH types (P>0.05). The prednisolone was used for remission induction in 37 patients; 86.4% (n: 32) achieved a complete response, 2.7% (n: 1) achieved a partial response, and four patients (10.8%) showed no response. Maintenance was attained by low-dose steroid plus thiopurine and relapse in steroid responders (n: 32) was 9.4% (n: 3) at 8, 12, and 48 months. A total of 36% (n: 24) had neither acute nor chronic treatment side effects. Bone marrow suppression was observed in five patients and hyperglycemia was observed in one patient (10.6 and 2.1%), respectively.
  
  
  CONCLUSIONS
  AIH type 1 prevails in children in a region of Turkey during the second decade of life. Low-dose corticosteroids combined with azathioprine are found.
authors.affiliation: aDepartment of Pediatric Gastroenterology, Hepatalogy and Nutrition, Gaziantep Children's Hospital, Gaziantep bDepartment of Pediatric Gastroenterology, Hepatology and Nutrition cDepartment of Pediatrics, Dr. Behcet Uz Children's Hospital dDepartment of Pediatric Gastroenterology, Hepatology and Nutrition, Ege University, Izmir, Turkey.
authors.forename: Miray
authors.initials: M
authors.lastname: Karakoyun
authors.forename: Cigdem O
authors.initials: CO
authors.lastname: Ecevit
authors.forename: Erhan
authors.initials: E
authors.lastname: Kilicoglu
authors.forename: Sema
authors.initials: S
authors.lastname: Aydogdu
authors.forename: Rasit V
authors.initials: RV
authors.lastname: Yagci
authors.forename: Funda
authors.initials: F
authors.lastname: Ozgenc
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001323:Autoantibodies / Q000097:blood; D001379:Azathioprine / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D019693:Hepatitis, Autoimmune / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use*; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011239:Prednisolone; D001379:Azathioprine