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Autoimmune Hepatitis in Children in Eastern Denmark

Vitfell-Pedersen, Joanna*; Jørgensen, Marianne Hørby; Müller, Klaus; Heilmann, Carsten

Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0b013e3182602b20
Hepatology and Nutrition
Abstract

Objectives: Autoimmune hepatitis (AIH) in childhood is a progressive chronic inflammatory liver disease. The aim of this study was to compare the clinical and biochemical characteristics of 33 paediatric patients diagnosed as having AIH with earlier described cohorts, and to examine the effect of early treatment strategies on the course of disease.

Methods: A population-based cohort of patients from January 1993 to September 2009 was identified prospectively, and the patient data were collected by a retrospective examination of the files.

Results: Twenty-nine patients had type 1 AIH, 2 had type 2, and 2 could not be categorised. Among the 33 children, 16 (48.5%) were girls and 17 (51.5%) were boys. Twenty-three (69.7%) of the patients had symptoms at presentation indistinguishable from acute viral hepatitis, but in 16 (69.6%) of those the liver biopsy showed cirrhosis. Twenty (60.6%) patients were treated with prednisolone and azathioprine at the time of remission, whereas 8 (24.2%) were treated with prednisolone. One (3%) patient did not experience remission during the observation period.

Conclusions: The patients in our study appeared similar to previously published cohorts, although a female predominance was not observed. Our data suggest that early treatment including both prednisolone and azathioprine could be more effective than prednisolone alone, even if randomised controlled paediatric studies comparing these 2 different treatment regimens are needed.

Author Information

*Sarcoma Unit, Royal Marsden Hospital, London, UK

Paediatric Clinic II, Institute for Inflammation Research, Copenhagen, Denmark.

Address correspondence and reprint requests to Carsten Heilmann, Pediatric Clinic II, Institute for Inflammation Research, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark (e-mail: carsten.heilmann@dadlnet.dk).

Received 13 May, 2011

Accepted 5 January, 2012

The authors report no conflicts of interest.

Copyright 2012 by ESPGHAN and NASPGHAN