AUTOIMMUNE HEPATITIS TYPE 1 IN A CHILD: CLINICAL CASE

Abstract

Autoimmune hepatitis (AIH) is a progressive hepatocellular inflammation of unknown etiology. As the main factor in the pathogenesis of AIH, a genetic predisposition, that is, immunoreactivity to self-antigens, is considered. AIH is considered to be a relatively rare disease. Currently, AIH types 1 and 2 are isolated. Autoimmune hepatitis is characterized by a wide range of clinical manifestations, from asymptomatic to severe, with or without extrahepatic manifestations, which can affect almost all organs and systems. In children, AIH has a more aggressive course, and early treatment is key to remission and prevention of cirrhosis or liver failure. It is important to remember that any type of AIH will naturally progress to cirrhosis if left untreated, and can sometimes progress even with therapy. Diagnosis of AIH is based on a combination of clinical features, laboratory evaluation, histopathology, and exclusion of other common liver disease. AIH type 1 occurs at any age, but is more common between 10 and 20 years of age or between 45 and 70 years of age. AIH type 2 accounts for about 3–4 % of all cases of AIH, most of the patients are children from 2 to 14 years old. A combination of type 2 AIH with insulin-dependent diabetes, vitiligo and thyroiditis is possible. Isolation of AIH type 3 is not supported by most experts. The considered clinical case serves as a vivid example for attracting the attention of pediatricians, gastroenterologists and doctors of other specialties to the problem of autoimmune hepatitis in children, as well as to the problem of diagnosing asymptomatic and latent forms of celiac disease.