Clinical Features And Biochemical Data Of Egyptian Children At Diagnosis Of Autoimmune Hepatitis

This study aimed to define epidemiological, clinical, biochemical and histological characteristics among children with Autoimmune Hepatitis (AIH) presenting to Mansoura University Children Hospital in relation to the outcome prognosis of these patients. This case-control study included 100 patients with autoimmune hepatitis aged 3-18y and 100 control age and sex matched healthy children. Laboratory investigations included complete blood count, liver enzymes, Alkaline phosphatase (ALP), total bilirubin, serum albumin, prothrombin time (PT), serum immunoglobulins concentrations, Antinuclear antibodies (ANAs), anti-smooth muscle antibody (SMA) and anti- LKM antibodies (Abs). Regarding liver biopsy, histological findings were recorded. Mean Hb level was (10.8±1.51). Median AST and ALT were (74.0 & 77.5 respectively). Eight patients had IgG > upper limit of normal, while 60 patients had IgG >1.1 times upper limit of normal, 64 patients were seronegative. AIH was definite in 62 patients. US were heterogenous among 25 patients. METAVIR activity score revealed that 45.0% of patients were A3 and 38.0% of patients were A2. Regarding treatment protocol, 82.0% received prednisolone only and 18.0% received prednisolone & Imuran. Remission achieved in 100.0% and relapse documented in just 18.0%. ROC analysis showed that IgG best cutoff values for AIH prediction were above 1111 with area under curve (AUC) was 0.939 (P=≤0.001). So, there was significant disease severity at presentation, as evidenced by advanced histologic activity and fibrosis in majority. Markedly, a high rate of seronegativity was observed. Despite this severity, standard immunosuppressive therapy achieved 100% remission rate, although 18% relapse rate highlights the chronic nature of the disease.