Evaluation of patients with autoimmune hepatitis: eleven years of experience

Aim: This study aimed to review a series of patients with autoimmune hepatitis in terms of disease pattern, laboratory results, treatment outcomes and adverse effects of treatment.Material and Method: Children with autoimmune hepatitis were retrospectively reviewed. In all patients, viral and metobolic eitologies were excluded. Patients were classified as type-1, type-2 and non-classified type, as well as acute and chronic groups. Treatment response and cessation of treatment were evaluated.Results: Patients were beetween 4 and 17 years old (12±2.68 years). Twenty patients were female, 11 patients were male. Seventeen patients were in acute and 14 patients were in chronic group; 18 of them were in type-1, 6 of them in type-2 and 7 of them were in non-classified type. Deflazacort was started in all patients. Azathioprine (2 mg/kg/day) was added to 10 patients with late response at the end of the third month. Deflazacort dosage was decreased at 6-8 weeks intervals and continued at a maintanance dosage of 5 mg/day. After a two-year period complete response was obtained in 24, partial response was obtained in 5 patients. No response was obtained in 2 patients. In the nine-year follow-up period, treatment was ended in 6 patients. In one patient, there was a recurrance in 6 months; the remaining 5 patients are still being followed up without a problem. Despite treatment portal hypertension was observed in 5 patients.Conclusions: Early diagnosis and treatment of childhood autoimmune hepatitis can decrease the risk of progression to cirrhosis and can increase the survival. Deflazocort can be a choice instead of prednisolone because of lesser side effects and efficiancy in treatment. (Turk Arch Ped 2012; 47: 28-32)