Evaluation of patients with autoimmune hepatitis: eleven years of experience

Abstract

Aim: This study aimed to review a series of patients with autoimmune hepatitis in terms of disease pattern nbsp; laboratory results treatment outcomes and adverse effects of treatment Material and Method: Children with autoimmune hepatitis were retrospectively reviewed In all patients viral and metobolic eitologies were excluded Patients were classified as type 1 type 2 and non classified type as well as acute and chronic groups Treatment response and cessation of treatment were evaluated Results: Patients were beetween 4 and 17 years old 12 plusmn;2 68 years Twenty patients were female 11 patients were male nbsp; Seventeen patients were in acute and 14 patients were in chronic group; 18 of them were in type 1 6 of them in type 2 and 7 of them were in non classified type nbsp; Deflazacort was started in all patients Azathioprine 2 mg kg day was added to 10 patients with late response at the end of the third month Deflazacort dosage was decreased at 6 8 weeks intervals and continued at a maintanance dosage of 5 mg day After a two year period complete response was obtained in 24 partial response was obtained in 5 patients No response was obtained in 2 patients In the nine year follow up period treatment was ended in 6 patients In one patient there was a recurrance in 6 months; the remaining 5 patients are still being followed up without a problem Despite treatment portal hypertension was observed in 5 patients Conclusions: Early diagnosis and treatment of childhood autoimmune hepatitis can decrease the risk of progression to cirrhosis and can increase the survival Deflazocort can be a choice nbsp; instead of prednisolone because of lesser side effects and efficiancy in treatment Turk Arch Ped 2012; 47: 28 32

Keywords

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Otoimmün hepatitli olgularımızın irdelenmesi: 11 yıllık deneyimimiz

Öz

Amaç: Otoimmün hepatit tanılı olgularımızın klinik ve laboratuvar verilerini tedavi sonuçlarını ve nbsp; tedavi yan etkilerini irdelemeyi amaçladık Gereç ve Yöntem: Otoimmün hepatit tanılı olguların dosyaları geriye dönük olarak incelendi nbsp; Tüm olgularda viral ve metabolik nedenler dışlandı Olgular tip 1 tip 2 tanımlanamayan tip ve ayrıca akut kronik olarak gruplandırıldı Olguların tedavi yanıtı ve tedavi sonlandırılma bilgileri değerlendirildi. 

Bulgular: Olgular 4 17 yaş 12 plusmn;2 68 yıl arasında olup 20 rsquo;si kız 11 rsquo;i erkekti Olguların 17 rsquo;si akut 14 rsquo;ü kronik; 18 rsquo;i tip 1 altısı tip 2 ve yedisi tanımlanamayan tip idi Tüm olgulara deflazakort başlandı Geç yanıt alınan 10 olguya üçüncü ayın sonunda azatiyopirin 2 mg kg gün eklendi Deflazakort 6 8 haftada bir azaltılarak 5 mg gün dozuyla devam edildi İki yılın sonunda 24 olgu tam yanıtlı beş olgu kısmi yanıtlı iki olgu ise yanıtsız olarak değerlendirildi Dokuz nbsp; yıllık izlem süresince altı olgunun nbsp; tedavisi sonlandırıldı Bir olguda nbsp; altı ay nbsp; sonra tekrarlama oldu Tedavisi kesilen nbsp; beş olgu hala sorunsuz olarak izlenmektedir Tedaviye rağmen beş olguda portal hipertansiyon bulguları gelişti.

Çıkarımlar: Çocukluk yaşı otoimmün hepatitinin erken tanı ve tedavisi siroza ilerleyiş hızını azaltmakta ve yaşam süresini uzatmaktadır Deflazakortun tedavideki etkinliği ve yan etkilerinin azlığı göz önüne alındığında otoimmün hepatit tanılı çocuklarda kullanılabileceği görüşündeyiz.

Anahtar Kelimeler

• Azatiyopirin
• çocuk
• deflazakort
• otoimmün hepatit

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