Pediatric Autoimmune Hepatitis

被引:0
|
作者
Nonga D. [1 ]
Amendola M. [2 ]
Serio J. [3 ]
Ayers M. [1 ]
Taylor A. [4 ]
Squires J.E. [1 ]
机构
[1] Division of Gastroenterology, Hepatology, and Nutrition, UPMC Children’s Hospital of Pittsburgh, One Children’s Hospital Drive, 6thFloor FP, 4401 Penn Avenue, Pittsburgh, 15224, PA
[2] Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
[3] Department of Pharmacy, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
[4] Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
关键词
Acute liver failure; Autoimmune liver disease; Children; Chronic liver disease; Immunosuppression; Liver transplant;
D O I
10.1007/s40746-023-00271-4
中图分类号
学科分类号
摘要
Purpose of Review: Autoimmune hepatitis (AIH) is a chronic progressive autoinflammatory disease of the liver caused by the dysregulation of an individual’s immune response. As discovery in science and innovation in clinical care have been reported, we look to summarize the most up-to-date clinical advances and management strategies in pediatric AIH. Recent Findings: Discovery related to genetic predisposition, epigenetic modification, and environmental triggers has been implicated in the etiopathogenesis of AIH and enabled a greater understanding of the disease and its management. Still, diagnosis in children is dependent on adult-derived scoring systems that are invasive and imperfect. Treatment regimens with immunosuppressive agents have been well established and initial responses are generally favorable. However, side effects can be significant, medication titration can be variable, and relapses are common. Medication intolerant or refractory cases present unique challenges in both prognosis and alternative therapeutic opportunities. Summary: In children, improvements in strategies that encompass diagnostic and prognostic tools to optimize care and predict outcomes, as well as establishing learning health network approaches to care constitute areas of ongoing and future discovery. © 2023, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
引用
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页码:106 / 121
页数:15
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