Steroid Free Treatment of Autoimmune Hepatitis in Selected Children

Wehrman, Andrew; Waisbourd‐Zinman, Orith; Shah, Ankur; Hilmara, Didja; Lin, Henry C.; Rand, Elizabeth B.

doi:10.1016/j.jpeds.2018.12.070

Cited by 7 publications

(6 citation statements)

References 18 publications

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“…Therefore, prednisolone should be continuously tapered to the lowest dose that can maintain a complete biochemical response or stopped [ 262 , 263 ]. In some pediatric patients, complete biochemical response can be maintained with AZA monotherapy without glucocorticoids [ 172 , 261 , 264 , 265 ]. In a study that reduced the prednisolone dose or administered it every other day, the decrease in growth rate improved, but the final height of the patients was shorter than predicted [ 262 ].…”

Section: Treatmentmentioning

confidence: 99%

KASL clinical practice guidelines for management of autoimmune hepatitis 2022

2023

Clin Mol Hepatol

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Section: Treatmentmentioning

confidence: 99%

KASL clinical practice guidelines for management of autoimmune hepatitis 2022

2023

Clin Mol Hepatol

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“…Hastalar genellikle kesilmeden önce uzun süreli steroid tedavisine gereksinim duyarlar, yarısında ise tedavinin ilk bir yılı içinde steroid tedavisinin kesilebildiği bildirilmektedir (4) . Bu standart tedavi önerilerinin aksine küçük bir grup ile yapılan yeni bir çalışmada, asemptomatik OİH tanısı olan seçilmiş çocuklarda indüksiyon tedavisinde steroid kullanılmadan AZA monoterapisi ile remisyonun sağlanabildiği, yalnızca remisyonun süresinin indüksiyonda steroid kullanılan gruba göre daha uzun olduğu bildirilmektedir (18) .…”

Section: Tedavi̇unclassified

Autoimmune Hepatitis in Children

Aksoy¹,

Appak²,

Baran³

2021

TERH

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Autoimmune hepatitis is characterized by inflammation in liver histology, circulating autoantibodies, and increased levels of immunglobulin G, in the absence of a known etiology. There are different clinical types described in children. Because of the presentation of autoimmune hepatitis with different clinical findings, establishment of diagnosis may be difficult. In the last two decades, a a 6-fold increase in the incidence of autoimmune hepatitis has been reported thanks to update of diagnostic approaches and the increase in technical possibilities. Autoimmune hepatitis should be considered in the differential diagnosis of any liver disease not caused by viral and metabolic factors. Its association with other clinical conditions such as autoimmune thyroiditis, vitiligo, collagen and connective tissue disorders is already known. Although autoimmune hepatitis is a treatable disorder, it may cause cirrhosis and fulminant hepatitis that need liver transplantation without treatment. In this review, we aimed to present the clinical findings, diagnosis and treatment methods of autoimmune hepatittis in children in the light of current literature.

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“…However, with the risk of liver fibrosis progression, which is already present in AIH even when asymptomatic, 4 we should not underestimate the potential impact of a median time of almost 6 months to achieve "near" normalization of alanine aminotransferase, as reported in 8 patients receiving azathioprine only, 4 of them presenting bridging fibrosis at diagnosis. 1 Moreover, after 1 year, remission was achieved in only 2 of 8 patients; this outcome should not be considered as satisfactory.…”

mentioning

confidence: 94%

“…We read with interest the article by Wehrman et al 1 We agree that adverse effects of prednisone therapy have a significant physical and psychological impact in children and adolescents with autoimmune hepatitis (AIH). However, a reliable steroid-free regimen already exists using cyclosporine (CSA) instead of prednisone to induce and maintain remission.…”

mentioning

confidence: 99%