The prognosis of childhood autoimmune active hepatitis COCUKLUK CAGI OTOIMMUN KRONIK AKTIF HEPATITLI HASTALARIMIZIN PROGNOZU


Cullu F., Erkan T., KUTLU H. T. , Tumay G.

Cerrahpasa Tip Fakultesi Dergisi, cilt.25, sa.1, ss.49-55, 1994 (Diğer Kurumların Hakemli Dergileri) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 25 Konu: 1
  • Basım Tarihi: 1994
  • Dergi Adı: Cerrahpasa Tip Fakultesi Dergisi
  • Sayfa Sayıları: ss.49-55

Özet

The time to beginning and the duration of immunosuppressive therapy play a major role in the prognosis of autoimmune active hepatitis. Five autoimmune cases, who have been treated during the last 8 years in Cerrahpasa School of Medicine Pediatric Gastroenterology Department, were studied retrospectively. Three of patients were female, remaining two were male. The first clinic manifestation of 2 patients was prolongated icterus, 1 patient had recurrent icterus, 1 patient had hepatomegaly and the other had hepatic precoma. Before the treatment serum ALT-AST levels, immunoglobulins and smooth muscle antibodies were elevated in all cases. The hepatic biopsies indicated chronic active hepatitis. In the induction phase one of the patients was treated with steroid+azathioprine and the others were treated with steroid. Maintenance therapy was given as alternate day. The patient who presented with hepatic coma had died, the others followed up for 1.5-7.5 years. During the induction phase, 2 of the patients taking steroid only relapsed twice, the other patient relapsed once; for the reinduction steroid+azathioprine were used. During the remission phase, steroid and azathioprine were used. Remission was achieved in all patients. In one patient we have seen growth retardation. In autoimmune chronic active hepatitis steroid+azathioprine treatment should be started immediately after diagnose and should continue for a long time. We think that minimal dose of steroid in alternate day therapy does not effect the growth seriously.