Lidman K, Biberfeld G, Sterner G, Norberg R
Acta Paediatr Scand. 1977 Jan;66(1):73-9. doi: 10.1111/j.1651-2227.1977.tb07810.x.
Six girls and one boy with cronic active hepatitis (CAH) of unknown etiology were between 9 and 15 years at the clinical onset of their illness. After beginning immunosuppressive therapy the course of their disease was followed from one to ten years. All had markedly increased IgG, high titres of smooth muscle antibodies (SMA) and antinuclear antibodies of IgG class in the earliest serum specimens tested. Therapy resulted in an improved sense of well-being and a decrease in SGOT, IgG and titres of SMA. Very high titres of measles antibodies were observed in all cases. In one of the cases CAH manifested itself after measles and in another after rubella infection. The first case in our series of patients died of liver failure after 5 years of illness. The other patients have survived and are able to live a normal life. The possibility of CAH should be considered when children develop symptoms of hepatitis. Longterm immunosuppressive treatment with regular clinical and laboratory evaluation is important. Estimation of titres of SMA is an additional parameter of value in following of the activity of CAH in these young patients.
6名女童和1名男童患有病因不明的慢性活动性肝炎（CAH），临床发病时年龄在9至15岁之间。开始免疫抑制治疗后，对他们的病程进行了1至10年的跟踪。在最早检测的血清样本中，所有人的IgG均显著升高，平滑肌抗体（SMA）和IgG类抗核抗体滴度很高。治疗使患者的健康状况得到改善，血清谷草转氨酶（SGOT）、IgG和SMA滴度下降。所有病例均观察到非常高滴度的麻疹抗体。其中1例CAH在麻疹后出现，另一例在风疹感染后出现。我们系列患者中的首例在患病5年后死于肝衰竭。其他患者存活下来，能够过上正常生活。儿童出现肝炎症状时应考虑CAH的可能性。长期免疫抑制治疗并定期进行临床和实验室评估很重要。SMA滴度的测定是跟踪这些年轻患者CAH活动的另一个有价值的参数。
