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[Type 1 autoimmune hepatitis in children and adolescents: assessment of immunosuppressive treatment withdrawal].

AbstractOBJECTIVE:
To assess treatment withdrawal in children and adolescents with autoimmune hepatitis, with clinical and laboratory remission for a minimum period of 24 months, determining the relapse rate after treatment withdrawal.
METHODS:
This is a descriptive, retrospective and partially prospective study of 21 children and adolescents with type 1 autoimmune hepatitis treated at the Outpatient Division of Pediatric Hepatology, Teaching Hospital of Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil, between January 1986 and December 2001.
RESULTS:
We assessed 54 patients and selected 21, of whom 19 were female subjects (90.5%), aged between 5.7 and 17.6 years (median = 13.8 years), with a mean follow-up of 5.1+/-2.4 years (median = 4.4 years) and an average clinical and laboratory remission of 4.1+/-1.5 years (median = 4.1 years). Out of the 21 patients studied, 10 (47.6%) manifested some inflammatory activity that prevented the discontinuation of treatment, which was withdrawn in 11 patients (52.4%). Out of these, six patients (54.5%) presented reactivation of the disease and five maintained clinical and laboratory remission with a mean follow-up of 4+/-1 years (median = 3.9 years). The time interval between discontinuation of treatment and reactivation of the disease ranged from 29 days to 40.3 months (median = 2.2 months).
CONCLUSIONS:
We observed a high relapse rate (54.5%) in this group of patients with autoimmune hepatitis, which was more frequent within the first 12 months after treatment withdrawal, in addition to a high number of patients that presented some degree of inflammatory activity despite the long period of clinical and laboratory remission.
AuthorsAlexandre R Ferreira, Mariza Leitão Valadares Roquete, Francisco J Penna, Nivaldo H Toppa, Lúcia Porto Fonseca de Castro
JournalJornal de pediatria (J Pediatr (Rio J)) 2005 Jul-Aug Vol. 81 Issue 4 Pg. 343-8 ISSN: 0021-7557 [Print] Brazil
Vernacular TitleHepatite auto-imune tipo 1 em crianças e adolescentes: avaliação da suspensão do tratamento imunossupressor.
PMID16106321 (Publication Type: Evaluation Study, Journal Article)
Chemical References
  • Immunosuppressive Agents
Topics
  • Adolescent
  • Biopsy
  • Child
  • Child, Preschool
  • Epidemiologic Methods
  • Female
  • Hepatitis, Autoimmune (drug therapy, pathology)
  • Humans
  • Immunosuppressive Agents (therapeutic use)
  • Infant
  • Liver (pathology)
  • Male
  • Recurrence
  • Remission Induction
  • Time Factors
  • Withholding Treatment

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