Nagi Salma Abdel Megeed, Yehia Sania Ali, Elhagali Yasmen Abdelaziz, Elkholy Shimaa Saad, Abd-Elaati Basma Mahmoud
Pediatric Hepatology, Gastroenterology and Nutrition Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia, Egypt.
Epidemiology and Preventive Medicine Department, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia, Egypt.
Clin Exp Hepatol. 2024 Mar;10(1):53-61. doi: 10.5114/ceh.2024.136927. Epub 2024 Mar 28.
To investigate whether serum ferritin and vitamin D levels before starting autoimmune hepatitis (AIH) treatment have a role in disease prognosis regarding a therapeutic response.
The prospective study included 100 children diagnosed with AIH according to simplified criteria for diagnosis of AIH. They attended the Pediatric Hepatology Department, National Liver Institute, Menoufia University. The patients underwent measurement of liver transaminases before starting AIH treatment after 6 months from starting therapy. They underwent liver biopsy before starting treatment for proper diagnosis, grading, and staging; only 25 cases were compliant and underwent liver biopsy before treatment withdrawal.
Serum ferritin and 25 hydroxy vitamin D levels were significantly higher among those with a complete response (1000-3100 ng/ml, 29-48 ng/ml) than a partial response (550-600 ng/ml, 23-28 ng/ml) and non-response (29.28-92.14, 2.16-8.72) ( < 0.001).
Our study showed a relation between serum vitamin D before starting AIH treatment, the severity of AIH and response to therapy. This opens a new area of research on the potential use of vitamin D in patients with AIH. Also, hyperferritinemia at the diagnosis can predict the treatment response.
探讨自身免疫性肝炎（AIH）治疗开始前的血清铁蛋白和维生素D水平在疾病治疗反应预后方面是否起作用。
这项前瞻性研究纳入了100名根据AIH简化诊断标准确诊的儿童。他们就诊于曼努菲亚大学国家肝脏研究所儿科肝病科。患者在开始AIH治疗后6个月以及开始治疗前接受肝转氨酶测量。他们在开始治疗前接受肝活检以进行准确诊断、分级和分期；只有25例患者配合并在停药前接受了肝活检。
完全缓解者（1000 - 3100 ng/ml，29 - 48 ng/ml）的血清铁蛋白和25羟维生素D水平显著高于部分缓解者（550 - 600 ng/ml，23 - 28 ng/ml）和无反应者（29.28 - 92.14，2.16 - 8.72）（P < 0.001）。
我们的研究表明，AIH治疗开始前的血清维生素D水平与AIH的严重程度及治疗反应之间存在关联。这为AIH患者中维生素D潜在用途的研究开辟了新领域。此外，诊断时的高铁蛋白血症可预测治疗反应。
