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Pediatric Autoimmune Hepatitis

  • Pediatric Gastroenterology (SA Saeed and E Mezoff, Section Editors)
  • Published:
Current Treatment Options in Pediatrics Aims and scope Submit manuscript

Abstract

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.

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Authors and Affiliations

  1. Division of Gastroenterology, Hepatology, and Nutrition, UPMC Children’s Hospital of Pittsburgh, One Children’s Hospital Drive, 6thFloor FP, 4401 Penn Avenue, Pittsburgh, PA, 15224, USA

    Dieudonne Nonga MD, Mary Ayers MD & James E. Squires MD, MS

  2. Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    Maria Amendola MD

  3. Department of Pharmacy, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    Jordan Serio PharmD, BCPPS

  4. Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Amy Taylor MD

Authors
  1. Dieudonne Nonga MD
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  2. Maria Amendola MD
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  3. Jordan Serio PharmD, BCPPS
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  4. Mary Ayers MD
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  5. Amy Taylor MD
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  6. James E. Squires MD, MS
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Corresponding author

Correspondence to James E. Squires MD, MS.

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Conflicts of Interest

Dieudonne Nonga declares no conflict of interest. Maria Amendola declares that she has no conflict of interest. Jordan Serio declares no conflict of interest. Mary Ayers declares that she has no conflict of interest. Amy Taylor declares that she has no conflict of interest. James E. Squires declares that he has no conflict of interest.

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Nonga, D., Amendola, M., Serio, J. et al. Pediatric Autoimmune Hepatitis. Curr Treat Options Peds 9, 106–121 (2023). https://doi.org/10.1007/s40746-023-00271-4

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