“Diagnostic and therapeutic study of pediatric autoimmune hepatitis: a single-center study”

Introduction Untreated pediatric autoimmune hepatitis (AIH) causes significant morbidity. The scope of research coming from Alexandria is limited, which poses a challenge for understanding some of the clinical and biochemical aspects of the disease. Aim To describe the clinical and biochemical characteristics of 17 pediatric AIH patients and perform laboratory evaluations before and after immunosuppressive treatmentat Alexandria University Children Hospital. Patients and methods Seventeen patients, aged 6.24 ± 2.38 years were diagnosed according to the International Autoimmune Hepatitis Group diagnostic criteria, to be included in an interventional prospective study for pediatric AIH. Baseline clinical characteristics and autoantibody tests as well as the AIH subtype, were recorded. Key biochemical parameters such as total serum immunoglobulin G at presentation, alanine aminotransferase, aspartate aminotransferase, total and direct serum bilirubin, albumin, platelets, and international normalized ratio, were assessed at diagnosis and repeated at the 6-month follow-up. Statistical analysis was done. Ethical approval and parents consent were obtained. Results The median duration of the presenting symptoms was 1.0 months. Different presenting manifestations were recorded. AIH type I was the most common (64.7%), while AIH type II (11.8%) was of lower prevalence. Single case of seronegative AIH was diagnosed. All aspects of liver profile were improved at the end of the study. Complete remission was attained in 94.1% of cases. Conclusion The dominant type of AIH was type I, achieving significant biochemical remission in the majority of the cohort (94.1%) and an infrequent relapse rate (5.9%) when matched with similar researches in different localities. Findings emphasize the significance of initial corticosteroid ± azathioprine treatment in pediatric AIH.