Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec 23;15(12):e0239964.
doi: 10.1371/journal.pone.0239964. eCollection 2020.

Clinical characteristics of paediatric autoimmune hepatitis at a referral hospital in Sub Saharan Africa

Taiba Jibril Afaa  1 , Kokou Hefoume Amegan-Aho  2 , Matilda Tierenye Dono  3 , Eric Odei  4 , Yaw Asante Awuku  5
Affiliations

Clinical characteristics of paediatric autoimmune hepatitis at a referral hospital in Sub Saharan Africa

Taiba Jibril Afaa et al. PLoS One. .

Abstract

Background: Autoimmune hepatitis (AIH) is a progressive inflammatory liver disease of unknown aetiology. The number of reported AIH cases is increasing in the developed countries but the same cannot be said about sub Saharan Africa (SSA). Paediatric AIH diagnosis is usually missed and patients present with decompensated liver disease. Our study highlights the clinical profile of paediatric AIH cases at a referral hospital in Ghana.

Methods: This is a retrospective review of all cases of children diagnosed with autoimmune hepatitis at the gastroenterology clinic in Korle Bu Teaching Hospital, Accra, Ghana. Data was extracted from the patients' records from April 2016 to October 2019. These children were diagnosed based on the presence of autoantibodies, elevated immunoglobulin G and histologic presence of interphase hepatitis with the exclusion of hepatitis A, B, C and E depending on their clinical presentation, Wilson's disease, HIV, Schistosomiasis and sickle cell disease.

Results: Thirteen patients aged between 5 years to 13 years with a mean age of 10 years were diagnosed with AIH. All the patients had type 1 AIH with majority 8 (61.5%) being females. Most of the children presented with advanced liver disease with complications. Three patients had other associated autoimmune diseases. The patients were treated with prednisolone with or without azathioprine depending on the severity of the liver disease.

Conclusion: Majority of paediatric AIH presents with advanced liver disease. There is the need for early detection to change the natural history of AIH in SSA.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Histology of autoimmune hepatitis showing interphase hepatitis with periportal inflammation dominated by lymphocytes.
See this image and copyright information in PMC

References

    1. Liberal R, Grant CR, Mieli-Vergani G, Diego Vergani D. Autoimmune hepatitis: a comprehensive review. J Autoimmun. 2013; 126–139. 10.1016/j.jaut.2012.11.002 - DOI - PubMed
    1. Pathak S, Kamat D. Autoimmune Hepatitis in Children. Pediatr Ann. 2018; 47(2):e81–e86. 10.3928/19382359-20180126-01 - DOI - PubMed
    1. Kerkar N, Naon H. Autoimmune Liver Disease in Children. Ann Pediatr Child Health 2015; 3(2): 1045.
    1. Mieli-Vergani G, Vergani D, Baumann U, Czubkowski P, Debray D, Dezsofi A, et al. Diagnosis and Management of Pediatric Autoimmune Liver Disease: ESPGHAN Hepatology Committee Position Statement. J Pediatr Gastroenterol Nutr. 2018; 66(2):345–360. 10.1097/MPG.0000000000001801 - DOI - PubMed
    1. Guo L, Zhou L, Zhang N, Deng B, Wang B. Extrahepatic Autoimmune Diseases in Patients with Autoimmune Liver Diseases: A Phenomenon Neglected by Gastroenterologists. Gastroenterol Res Pract. 2017;22376231 10.1155/2017/2376231 - DOI - PMC - PubMed