Abstract

DELGADO, María Antonieta et al. Prognosis and Treatment Response in pediatric patients with Autoimmune Hepatitis. Gen [online]. 2012, vol.66, n.4, pp.237-243. ISSN 0016-3503.

Introduction: Autoimmune hepatitis (AIH) is a progressive, chronic disease of unknown etiology, characterized for the presence of circulating autoantibodies and hyper gammaglobulinemia. Most patients respond to immunosuppressive treatment, otherwise, liver parenchimal is progressively destroyed leading to cirrhosis and liver failure. Early withdrawal of therapy might cause relapses and increased risk to cirrhosis. Objective: To assess HAI outcome and treatment response in pediatric patients. Methods: By a retrospective and descriptive analysis we evaluated 51 patients who attended the Pediatric Gastroenterology Department at the “J.M de Los Rios” Children Hospital from April 1996 to September 2010. 48 of these 51 patients have been on immunosuppressive treatment for more than one year. Results: 79.2 % of patients experienced remission at 20.4 ± 13.8 months, 25 % relapsed. 10/48 (20.8 %) showed incomplete response and 38.5 % had no adherence to treatment (p = 0.001). 33/48 (68.8 %) had complications, being the most frequent portal hypertension 64.6 %, following by osteoporosis and osteopenia 27,2 %, and 18.8 % developed cirrhosis.3 (8.5 %) patients had remission with normal liver biopsy after approximately 7 years, so treatment was discontinued, maintaining remission for 3.5 years. Two patients required liver transplantation. Conclusions: Most patients responded well to immunosuppressive therapy. 25 % suffered relapses. The incomplete response was significantly associated to non-adherence to treatment.

Keywords : autoimmune hepatitis; treatment; remission; relapse; adherence.