Otoimmün hepatitli olgularımızın irdelenmesi: 11 yıllık deneyimimiz

Abstract

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 etiologies 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 percent of the patients were in the acute group and 14% were in the chronic group; 18% were in the type-1 group, 6% were in the type-2 group and 7% were in the non-classified type group. Deflazacort was started in all patients. Azothiopurine (2 mg/kg/day) was added in 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 maintenance dosage of 5 mg/day. After a two-year period complete response was obtained in 24 patients and partial response was obtained in 5 patients. No response was obtained in 2 patients. During 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 its efficiency in treatment and lesser side effects. (Turk Arch Ped 2012; 47: 29-34)