Incidence and clinical features of autoimmune hepatitis in the province of santa fe (Argentina)

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Abstract

Objetives:

To investigate the incidence and clinical features of autoimmune hepatitis (AIH) in children from the province of Santa Fe, Argentina, over ten years.

Methods:

From the records of all of the pediatric hepatologists in the province of Santa Fe, Argentina, we reviewed the clinical charts of patients < 18 years who were diagnosed with AIH (simplified score >6 points) and followed between January 2003 and December 2013. Population data were extracted from the 2010 national census. Values were expressed as percentages and median +/- interquartile range. Mann-Whitney test was used for comparison between groups.

Results:

67 patients fulfilled inclusion criteria, from which 11 (16%) were later reclassified as “autoimmune sclerosing cholangitis” (ASC) according to biochemical, histological and radiological findings. A final sample of 56 patients (39 F) with AIH was analyzed, giving an annual incidence of 0.56/100,000. Median age at presentation was 8 (5.7 -11) years, and the median follow-up was 4 (2–7) years. Type 1 AIH was diagnosed in 89%. An acute presentation was observed in 53%, while 13 (23%) showed cirrhosis on initial biopsy. Prednisone (87%), and azathioprine (60%) were the most common drugs prescribed. At the end of follow-up, 53/56 (95%) were alive, including four patients (7%) who underwent liver transplantation.

Conclusion:

AIH has an estimated incidence of 0.56/100000/year in children from the province of Santa Fe (Argentina). Overall survival was 95%. A subgroup of patients diagnosed as AIH develops predominant biliary disease and should be better classified as ASC.

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