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Clinical presentation of autoimmune hepatitis in Pakistani children
Ghous Bux Somroo1, Ayesha Aslam Rai1, Nasir Hassan Luck1
1Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi, Pakistani.
Insights
Autoimmune hepatitis (AIH) primarily affects female children, who present later than males. Type I AIH is most common, but Type II AIH is more prevalent in males, who also show elevated GGT levels.
Area of Science:
- Pediatric Hepatology
- Autoimmune Diseases
- Clinical Biochemistry
Background:
- Autoimmune hepatitis (AIH) is a leading cause of pediatric end-stage liver disease (ESLD).
- Limited data exists on AIH in children from Pakistan.
- This study investigates the clinical and biochemical profiles of pediatric AIH patients in Pakistan.
Purpose of the Study:
- To analyze the clinical presentation and biochemical characteristics of autoimmune hepatitis in children.
- To identify demographic and disease-specific differences between male and female pediatric AIH patients.
- To describe the prevalence of AIH types and associated biochemical markers in a Pakistani pediatric cohort.
Main Methods:
- A cross-sectional study was conducted from January 2005 to June 2016 at SIUT, Karachi.
- Included patients were children up to 18 years diagnosed with AIH using International Autoimmune Hepatitis Group (IAIHG) criteria.
- Data collected included biochemical, serological, sonographic, demographic information, and liver biopsy results.
Main Results:
- Fifty-one pediatric patients were enrolled, with females comprising 68.6%.
- The mean age of presentation was approximately 10 years; males presented significantly earlier (p=0.007).
- Jaundice was the most common symptom; Type I AIH was most frequent, while Type II AIH was more common in males (p=0.019) with elevated GGT (p=0.001).
Conclusions:
- Autoimmune hepatitis predominantly affects female children, who tend to present at a later age compared to males.
- Type I AIH is the most common form, whereas Type II AIH is more prevalent in males.
- Males with Type II AIH exhibited significantly higher GGT levels.
Introduction:
Autoimmune hepatitis (AIH) is one of the most common disorder resulting in end stage liver disease (ESLD) among children. Scarce data is available in this regard from Pakistan. In this study we have analyzed clinical and biochemical parameters of children suffering from this disorder.
Methods:
It was a cross sectional study conducted in the Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation (SIUT) Karachi from January 2005 to June 2016. Patients aged up-to 18 years were included. AIH was diagnosed by using International Autoimmune hepatitis group (IAIHG) pre-treatment and simplified AIH score. Patients with both probable and definite score were included. Biochemical, serological, sonographic and demographics were recorded at the time of diagnosis, liver biopsy was also performed in most of the cases. Data was analyzed by using SPSS ver.20 and p-value of < 0.05 was considered significant.
Results:
Total 51 patients were enrolled most of them were females (68.6%). Mean age of presentation was around 10 years. Males had statistically significant earlier age of presentation, p-value = 0.007. The most common presenting complain was jaundice. Hypergammaglobulinemia is seen in almost all patients. Type I AIH was the most common entity while Type II AIH was statistically more significant in males p-value = 0.019. Raised GGT was also seen in male patient specifically in Type II AIH, p-value = 0.001.
Conclusion:
Autoimmune hepatitis predominantly affects female children who have late age of presentation as compare to the males. Type I AIH was the most common while Type II AIH was more common in males and they also had raised GGT.
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