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Clinical characteristics and outcomes in 50 children with autoimmune hepatitis: a retrospective study from a single
Yandi Yang1, Fan Yang2, Min Yang3
1The 82nd Group Army Hospital of PLA, Baoding, Hebei, China.
Insights
Most Chinese children with autoimmune hepatitis (AIH) survive with their native liver. Outcomes depend on cirrhosis at presentation, not immunosuppressive therapy type.
Area of Science:
- Hepatology
- Pediatric Gastroenterology
- Immunology
Background:
- Autoimmune hepatitis (AIH) is poorly understood in Chinese children.
- This study addresses the lack of data on AIH in this specific demographic.
Purpose of the Study:
- To investigate the clinical features of AIH in Chinese children.
- To identify predictors of outcomes in this pediatric cohort.
Main Methods:
- Retrospective review of 50 pediatric AIH cases (2015-2025) at a Beijing center.
- Analysis of clinical presentation, treatment, and outcomes.
Main Results:
- Type 1 AIH was most common (78.0%).
- Cirrhosis (48.0%) and liver failure (22.0%) were frequent at presentation.
- 85.4% survived with native livers; outcomes were independent of immunosuppressive drug choice.
- Low serum albumin and decompensated cirrhosis predicted poorer outcomes.
Conclusions:
- The majority of pediatric AIH patients in China achieve survival with native livers.
- Disease outcome is primarily influenced by the severity of cirrhosis at presentation, rather than the specific immunosuppressive treatment regimen used.
Objectives:
Little is known about autoimmune hepatitis (AIH) in Chinese children. The study aimed to explore the clinical characteristics and predictors of outcomes in the Chinese paediatric AIH cohort.
Methods:
A retrospective review of all paediatric AIH cases from 2015 to 2025 was conducted at a single centre in Beijing, China.
Results:
Of the 50 enrolled cases, 39 (78.0%) presented with type 1 AIH (consisting of 30 female children (60.0%); median age of 9.2 years). At presentation, 24 (48.0%) patients had cirrhosis, 11 (22.0%) had liver failure, and 10 (20.0%) had decompensated cirrhosis at presentation. Compared to type 1, children with type 2 were younger and had higher levels of serum alanine aminotransferase [270.0 (166.0, 599.0) U/L vs. 610.0 (510.0, 1231.0) U/L, p = 0.003] and aspartate aminotransferase [335.0 (172.0, 756.0) U/L vs. 576.0 (433.0, 1020.0) U/L, p = 0.013]; however, there was no statistical significance in the outcome between the two groups (p > 0.05). In 48 cases that received initial immunosuppressive treatment (glucocorticoid alone = 18, in combination with azathioprine = 20, or with mycophenolate mofetil = 10), 41 (85.4%) patients survived with a native liver, and there was no statistical difference in prognosis among the three types of immunosuppressive treatments. Serum albumin levels and decompensated cirrhosis at presentation were identified as independent factors influencing the likelihood of death or the need for liver transplantation (OR 0.814 [95% CI 0.670-0.989], p = 0.039; OR 0.146 [95% CI 0.022-0.963], p = 0.046).
Conclusion:
The majority of paediatric AIH patients survive with a native liver, and the outcome is not related to the type of immunosuppressive therapies but to decompensated cirrhosis at presentation.
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