Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, School Medicine, Federal University of Minas Gerais, Minas Gerais 30130-100, Brazil.
World J Gastroenterol. 2012 Sep 7;18(33):4470-3. doi: 10.3748/wjg.v18.i33.4470.
Autoimmune hepatitis (AIH) is a progressive inflammatory liver disorder that is rare in children and adolescents. AIH has a broad clinical spectrum and a quick response to treatment with corticosteroids and immunosuppressive medication. The available diagnosis criteria have limitations and should be evaluated in pediatric populations. Recently, some studies reported that the 2008 simplified diagnostic criteria for AIH could be used in children with high sensibility and specificity. In addition, the authors reported that globulin and immunoglobulin G levels can be used interchangeably for diagnostic purposes. They also demonstrated that the 2008 simplified criteria fail in identifying patients with fulminant hepatic failure. Here, we discuss the limitations of the use of these criteria in pediatric patients and the requirement of more studies to improve the diagnosis of AIH in children.
自身免疫性肝炎（AIH）是一种罕见于儿童和青少年的进行性炎症性肝脏疾病。AIH 具有广泛的临床谱，对皮质类固醇和免疫抑制药物治疗有快速反应。现有的诊断标准存在局限性，应在儿科人群中进行评估。最近，一些研究报告称，2008 年简化的 AIH 诊断标准可用于具有高敏感性和特异性的儿童。此外，作者还报告球蛋白和免疫球蛋白 G 水平可互换用于诊断目的。他们还表明，2008 年简化标准无法识别暴发性肝衰竭患者。在这里，我们讨论了这些标准在儿科患者中的使用限制，以及需要更多研究来提高儿童 AIH 的诊断水平。
