Serological markers of autoimmunity in children with hepatitis A

Abdel-Ghaffar, Tawhida Yassin; Sira, Mostafa Mohamed; Sira, Ahmad Mohamed; El-Sharawy, Ahmed A.; Naghi, Suzan El

doi:10.1097/meg.0000000000000413

Cited by 16 publications

(12 citation statements)

References 39 publications

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“…Autoantibody positivity, in particular in respect to SMA, is not unusual during the course of viral hepatitis, having been reported for hepatitis A, B, C and E [19,[25][26][27][28][29]. Usually, in the course of viral hepatitis SMA displays the non-specific V pattern [23], as detected in most of our HEV patients, and its presence is considered non-specific, though autoantibody positivity has been associated with more severe disease in chronic hepatitis C [30].…”

Section: Discussionsupporting

confidence: 52%

Autoimmune liver disease serology in acute hepatitis E virus infection

Beretta‐Piccoli

Ripellino

Gobbi

et al. 2018

Digestive and Liver Disease

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Section: Discussionsupporting

confidence: 52%

Autoimmune liver disease serology in acute hepatitis E virus infection

Beretta‐Piccoli

Ripellino

Gobbi

et al. 2018

Digestive and Liver Disease

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“…Other aetiologies of FHF with similar pathophysiological mechanism could be considered a good candidate for steroid therapy as well. We have previously reported the occurrence of autoantibodies and hypergammaglobulinemia in children with hepatitis A . Similar findings were reported by others …”

Section: Introductionsupporting

confidence: 92%

Steroid therapy in children with fulminant hepatitis A

Zakaria

El-Araby

Salama

et al. 2018

Journal of Viral Hepatitis

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Fulminant hepatic failure is a life-threatening disease. Hepatitis A virus (HAV) can cause fulminant hepatic failure and death in about 0.2% of cases. Extensive destruction of infected hepatocytes by immune-mediated lysis is thought to be the cause. We aimed to evaluate the use of steroid therapy in children with fulminant HAV. This study included 33 children with fulminant HAV in two groups. Steroid group: comprised of 18 children who received prednisolone (1 mg/kg/d) or its equivalent dose of methylprednisolone, and the nonsteroid group: comprised another 15 children who did not receive steroid therapy. Age and sex were matched for both groups (P > .05), and they were comparable regarding baseline clinical and laboratory characteristics. Of the steroid group, 15 patients survived and 3 died, while in the nonsteroid group, 4 patients survived and 11 died (P = .001). Of the living patients, 15 of 19 (78.9%) received steroids while only 3 of 14 (21.4%) of the dead patients received steroids (P = .001). Stepwise regression analysis showed that steroid therapy was the only independent variable associated with recovery (P = .001). Steroid therapy in children with fulminant HAV associated significantly with improved outcome and survival. Future studies on a larger population size are strongly recommended.

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“…We have read the study of Abdel-Ghaffar et al [1] with great interest. They have detected autoantibodies in 63% of children with acute hepatitis A virus (HAV) infection but none in healthy controls.…”

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confidence: 97%

More on autoimmune hepatitis and acute hepatitis A

Özaras

Tahan²,

Tabak³

2016

European Journal of Gastroenterology & Hepatology

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We have read the study of Abdel-Ghaffar et al.[1] with great interest. They have detected autoantibodies in 63% of children with acute hepatitis A virus (HAV) infection but none in healthy controls.Autoimmune hepatitis (AIH) is a chronic liver disease of unknown etiology and is characterized by hyperglobulinemia, the appearance of certain circulating autoantibodies, and inflammatory changes in liver histology. AIH may be triggered by many factors including drugs and viral hepatitis in predisposed individuals. In a pioneering study, Vento et al.[2] monitored 58 relatives of 13 patients with AIH prospectively for 4 years. Subclinical acute HAV infection developed in three patients, two of whom developed type 1 AIH within 5 months. They described an intrinsic defect in suppressor-inducer T cells mediating immune reactivity to a liver antigen (asialoglycoprotein receptor; located on the hepatocyte cell surface) in these patients.In the English literature, nine more cases of AIH [3-11], including our case report and a case of overlap syndrome [AIH/primary biliary cirrhosis (PBS)] [12] developed after acute HAV infection, have been published. Besides, a case of AIH after HAV vaccination [13] and two overlap syndromes after combined vaccine of HAV and hepatitis B virus (one AIH/PBS and one AIH/primary sclerosing cholangitis) [14] were reported. All the clinical data and the results of the study by Abdel-Ghaffar and colleagues support an association between AIH and acute HAV infection.

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Serological markers of autoimmunity in children with hepatitis A

Cited by 16 publications

References 39 publications

Autoimmune liver disease serology in acute hepatitis E virus infection

Autoimmune liver disease serology in acute hepatitis E virus infection

Steroid therapy in children with fulminant hepatitis A

More on autoimmune hepatitis and acute hepatitis A

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