POPLINE Document Number: 315166
Author(s):
Ferreira AR
Roquete ML
Penna FJ
Toppa NH
Source citation:
Jornal de Pediatria, 2002;78(4):309-14.
Abstract:
The aim of this study was to evaluate the clinical, laboratory and histopathological characteristics and the response to immunosuppression in children and adolescents with autoimmune hepatitis (AIH). The present research is a descriptive study consisting of 39 children and adolescents with AIH who receive care at the Department of Pediatric Gastroenterology of Hospital das Clínicas (UFMG) from 1986 to 1998. Children's age ranged from 1.6 to 17 years (mean 8.7 ± 3.49), most of them were females (87.2%). There were three types of clinical presentations: chronic (53.9%), acute (41%), and serious hepatic failure (5.1%). The most relevant laboratory parameters were the aminotransferases and g-globulin increase. Antinuclear antibodies were positive in 66.7% of the patients, while smooth muscle antibodies were positive in 52.8% and anti-LKM1 in 3% of the patients. In the histopathology the most important findings were the piecemeal necrosis (93.7%), moderate to severe portal inflammation (78.1%), definitive or incomplete cirrhosis (76.9%), absence of lesion of biliary ducts (93.7%) and presence of rosettes (90.6%). During the treatment, 77.8% obtained complete resolution, associated to side effects in 27.8% of them. Seven patients died (17.9%). During the treatment there was significant z score reduction (p< 0.05) for height/age. After carrying out this study, we observed that the typical characteristics of AIH were: female sex, several clinical presentations, increased aminotransferase, and hypergammaglobulinemia. Histopathology showed a predominance of incipient and/or definitive cirrhosis associated with moderate to severe portal inflammation and piecemeal necrosis. Treatment using corticosteroids and azathioprine, turned out to be effective. However, the reduction in the height/age z score probably represents an adverse effect of corticoid treatment. (author's)
Keywords:
BrazilIndex page
Research Report
Clinical Research
Children
Adolescents
Hepatitis
Autoimmune Response
Signs and Symptoms
Laboratory Examinations and Diagnoses
Treatment
Side Effects
South America, Eastern
South America
Latin America
Americas
Developing Countries
Research Methodology
Youth
Age Factors
Population Characteristics
Demographic Factors
Population
Viral Diseases
Diseases
Antibodies
Immunologic Factors
Immunity
Immune System
Physiology
Biology
Examinations and Diagnoses
Medical Procedures
Medicine
Health Services
Delivery of Health Care
Health