Resumo

OSPITALECHE, Mariángel; LAGOMARSINO, Graciela  e  PINCHAK, Catalina. Update on autoimmune hepatitis in pediatrics: Report of a clinical case and review of literature. Arch. Pediatr. Urug. [online]. 2016, vol.87, n.2, pp.115-124. ISSN 0004-0584.

Autoimmune hepatitis is a chronic and progressive inflammatory process of the liver, of unknown etiology. It is characterized by presenting increased levels of aminotransferases and immunoglobulin G (IgG), serum antibodies and histologic necro-inflamatory activity, with unknown pathology that may affect the liver. It is more frequent in women, Two types of autoimmune hepatitis are described, according to the antibodies found. Treatment is based on immunosuppression, with the objective of avoiding progression to cirrhosis and liver failure. Patients who do not respond or who present with severe liver failure may require liver transplant. The objective of the study is to review the topic based on a clinical case. The study presents the case of a 14 year old adolescent who is referred to be examined for possible autoimmune pathology. Initial diagnosis was probable autoimmune hepatitis, which presented with acute liver failure. Subsequently, when other etiologies were discarded (infectious and metabollic), positive antinuclear autoantibodies were present and liver hepatic biopsy evidenced cirrhosis, autoimmune cirrhosis was confirmed. Treatment was initiated with prednisone and azathioprine, being the clinical and lab response good. In most cases, timely diagnosis of autoimmune hepatitis and early initiation of treatment avoid progression of the disease and the need for a liver transplant.

Palavras-chave : AUTOIMMUNE HEPATITIS; LIVER CIRRHOSIS; AZATHIOPRINE; PREDNISONE.

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