• Features of the autoimmune hepatitis manifestation in children

Features of the autoimmune hepatitis manifestation in children

SOVREMENNAYA PEDIATRIYA.2017.6(86):80-86; doi 10.15574/SP.2017.86.80

Berezenko V. S., Mykhayluk K. Z.
SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine», Kyiv

Objective. To study clinical and morphological features of autoimmune hepatitis manifestation in children.
Materials and methods. The studying included anamnesis of disease and life, hereditary anamnesis, clinical presentation, estimated stage of fibrosis (measured on the scale METAVIR) and histological index of activity (Knodell), which based on the results of morphological study of liver biopsy, cytolysis markers (alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase), cholestasis (common bilirubin, alkaline phosphatase), mesenchymal-inflammatory syndrome (total protein, thymol test, ESR, γ-globulin, IgG, CIC), violation of protein-synthetic liver function (albumin, prothrombin index) hypocoagulation syndrome (INR, APTT) in 26 children with debut of autoimmune hepatitis before the prescription of immunosuppressive treatment.
Results: Autoimmune hepatitis in children is characterized by a nonspecific clinical picture, an aggressive and high-level inflammatory process in the liver, with a rapid progression of the disease (the stage of fibrosis >F2). The diagnosis was established at the stage of liver cirrhosis in 50% of the examined children. The duration of the disease and high activity of process are predictors of the progression of liver fibrosis.
Conclusions. The clinical picture of debut of autoimmune hepatitis determined by the severity of functional state violation of the liver and the activity of process in children. The manifestation of autoimmune hepatitis most often occurs in girls of pre-pubertal age. The presence of autoimmune diseases in the family in conditions of increased functional liver tests requires a detailed examination of these children for the purpose of early diagnosis of autoimmune hepatitis.
Key words: autoimmune hepatitis, manifestation, children, fibrosis, clinic, diagnostics.

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