nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-215-7-156-161nogr-2540Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL CASESДебют аутоиммунного гепатита после перенесенной новой коронавирусной инфекции (COVID-19) у ребенка 11 месяцевThe debut of autoimmune hepatitis after a new coronavirus infection (COVID-19) in an 11-month-old childhttps://orcid.org/0000-0003-3879-7716ЛебедеваТ. Н.LebedevaT. N.giletan@mail.ruhttps://orcid.org/0000-0001-5623-3696МарчуковаА. Ю.MarchukovaA. Yu.noemail@neicon.ruБондарьК. Г.BondarK. G.noemail@neicon.ruИнститут «Медицинская академия имени С. И. Георгиевского» ФГАОУ ВО «Крымский федеральный университет имени В. И. Вернадского»; Государственное бюджетное учреждение здравоохранения Республики Крым «Республиканская детская клиническая больница»РоссияMedical Academy named after S. I. Georgievsky of Vernadsky CFU; Republican Children’s Clinical HospitalRussian FederationГосударственное бюджетное учреждение здравоохранения Республики Крым «Республиканская детская клиническая больница»РоссияRepublican Children’s Clinical HospitalRussian Federation20230703202407156161Copyright © Лебедева Т.Н., Марчукова А.Ю., Бондарь К.Г., 20242024Лебедева Т.Н., Марчукова А.Ю., Бондарь К.Г.Lebedeva T.N., Marchukova A.Y., Bondar K.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/2540

Во многих странах фиксируют случаи тяжелого поражения печени у детей. Ранее перенесенная или существующая коронавирусная инфекция приводит к нарушению иммунного ответа организма на инфекции, что может приводить к тяжелому воспалению, вызвавшему поражение печени. В данной статье описан клинический случай аутоиммунного гепатита 2-го типа, высокой степени биохимической активности, дебютировавшего у ребенка 11месяцев, после перенесенной новой коронавирусной инфекции (COVID-19). Представленный клинический пример демонстрирует необходимость тщательного и всестороннего обследования детей с первыми клиническими проявлениями поражения печени и своевременного назначения терапии.

In many countries fix cases of severe liver damage in children are recorded. A previous or existing coronavirus infection leads to a disruption in the body’s immune response to infections, which can lead to severe inflammation that caused liver damage. This article describes a clinical case of type 2 autoimmune hepatitis, a high degree of biochemical activity, that debuted in an 11-month-old child after a new coronavirus infection (COVID-19). The presented clinical example demonstrates the need for a thorough and comprehensive examination of children with the first clinical manifestations of liver damage and timely prescription of therapy

аутоиммунный гепатитдетиновая коронавирусная инфекция (COVID-19)кортикостероидыautoimmune hepatitischildrennew coronavirus infection (COVID-19)corticosteroidsReferencesKrawitt EL. Autoimmune hepatitis. N Engl J Med. 2006 Jan 5;354(1):54-66. doi: 10.1056/NEJMra050408.Krawitt EL. Autoimmune hepatitis. N Engl J Med. 2006 Jan 5;354(1):54-66. doi: 10.1056/NEJMra050408.Union of Pediatricians of Russia. Clinical recommendations. [Autoimmune hepatitis in children]. 2016. (in Russ.)@@ Союз педиатров России. Клинические рекомендации. Аутоиммунный гепатит у детей. 2016.Union of Pediatricians of Russia. Clinical recommendations. [Autoimmune hepatitis in children]. 2016. (in Russ.)@@ Союз педиатров России. Клинические рекомендации. Аутоиммунный гепатит у детей. 2016.Grønbæk L, Vilstrup H, Jepsen P. Autoimmune hepatitis in Denmark: incidence, prevalence, prognosis, and causes of death. A nationwide registry-based cohort study. J Hepatol. 2014 Mar;60(3):612-7. doi: 10.1016/j.jhep.2013.10.020.Grønbæk L, Vilstrup H, Jepsen P. Autoimmune hepatitis in Denmark: incidence, prevalence, prognosis, and causes of death. A nationwide registry-based cohort study. J Hepatol. 2014 Mar;60(3):612-7. doi: 10.1016/j.jhep.2013.10.020.Lohse A. W., Mieli-Vergani G. Autoimmune hepatitis. J Hepatol. 2011 Jul;55(1):171-82. doi: 10.1016/j.jhep.2010.12.012.Lohse A. W., Mieli-Vergani G. Autoimmune hepatitis. J Hepatol. 2011 Jul;55(1):171-82. doi: 10.1016/j.jhep.2010.12.012.Zachou K., Muratori P., Koukoulis G. K., Granito A., Gatselis N., Fabbri A., Dalekos G. N., Muratori L. Review article: autoimmune hepatitis - current management and challenges. Aliment Pharmacol Ther. 2013 Oct;38(8):887-913. doi: 10.1111/apt.12470.Zachou K., Muratori P., Koukoulis G. K., Granito A., Gatselis N., Fabbri A., Dalekos G. N., Muratori L. Review article: autoimmune hepatitis - current management and challenges. Aliment Pharmacol Ther. 2013 Oct;38(8):887-913. doi: 10.1111/apt.12470.Alvarez F., Berg P. A., Bianchi F. B. et al.International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol. 1999 Nov;31(5):929-38. doi: 10.1016/s0168-8278(99)80297-9.Alvarez F., Berg P. A., Bianchi F. B. et al.International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol. 1999 Nov;31(5):929-38. doi: 10.1016/s0168-8278(99)80297-9.Hennes E. M., Zeniya M., Czaja A. J. et al.; International Autoimmune Hepatitis Group. Simplified criteria for the diagnosis of autoimmune hepatitis. Hepatology. 2008 Jul;48(1):169-76. doi: 10.1002/hep.22322.Hennes E. M., Zeniya M., Czaja A. J. et al.; International Autoimmune Hepatitis Group. Simplified criteria for the diagnosis of autoimmune hepatitis. Hepatology. 2008 Jul;48(1):169-76. doi: 10.1002/hep.22322.Manns M. P., Czaja A. J., Gorham J. D., Krawitt E. L., Mieli-Vergani G., Vergani D. et al. Diagnosis and management of autoimmune hepatitis. Hepatology. 2010;51:2193-2213. doi: 10.1002/hep.23584.Manns M. P., Czaja A. J., Gorham J. D., Krawitt E. L., Mieli-Vergani G., Vergani D. et al. Diagnosis and management of autoimmune hepatitis. Hepatology. 2010;51:2193-2213. doi: 10.1002/hep.23584.Gleeson D., Heneghan M. A.; British Society of Gastroenterology. British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis. Gut. 2011 Dec;60(12):1611-29. doi: 10.1136/gut.2010.235259.Gleeson D., Heneghan M. A.; British Society of Gastroenterology. British Society of Gastroenterology (BSG) guidelines for management of autoimmune hepatitis. Gut. 2011 Dec;60(12):1611-29. doi: 10.1136/gut.2010.235259.Manns M., Gerken G., Kyriatsoulis A., Staritz M., Meyer zum Büschenfelde K. H. Characterisation of a new subgroup of autoimmune chronic active hepatitis by autoantibodies against a soluble liver antigen. Lancet. 1987 Feb 7;1(8528):292-4. doi: 10.1016/s0140-6736(87)92024-1.Manns M., Gerken G., Kyriatsoulis A., Staritz M., Meyer zum Büschenfelde K. H. Characterisation of a new subgroup of autoimmune chronic active hepatitis by autoantibodies against a soluble liver antigen. Lancet. 1987 Feb 7;1(8528):292-4. doi: 10.1016/s0140-6736(87)92024-1.Boberg K. M., Chapman R. W., Hirschfield G. M., Lohse A. W., Manns M. P., Schrumpf E.; International Autoimmune Hepatitis Group. Overlap syndromes: the International Autoimmune Hepatitis Group (IAIHG) position statement on a controversial issue. J Hepatol. 2011 Feb;54(2):374-85. doi: 10.1016/j.jhep.2010.09.002.Boberg K. M., Chapman R. W., Hirschfield G. M., Lohse A. W., Manns M. P., Schrumpf E.; International Autoimmune Hepatitis Group. Overlap syndromes: the International Autoimmune Hepatitis Group (IAIHG) position statement on a controversial issue. J Hepatol. 2011 Feb;54(2):374-85. doi: 10.1016/j.jhep.2010.09.002.Mieli-Vergani G., Heller S., Jara P., Vergani D. et al. Autoimmune hepatitis. J Pediatr Gastroenterol Nutr. 2009 Aug;49(2):158-64. doi: 10.1097/MPG.0b013e3181a1c265.Mieli-Vergani G., Heller S., Jara P., Vergani D. et al. Autoimmune hepatitis. J Pediatr Gastroenterol Nutr. 2009 Aug;49(2):158-64. doi: 10.1097/MPG.0b013e3181a1c265.Gregorio G. V., Portmann B., Karani J., Harrison P., Donaldson P. T., Vergani D., Mieli-Vergani G. Autoimmune hepatitis/sclerosing cholangitis overlap syndrome in childhood: a 16-year prospective study. Hepatology. 2001 Mar;33(3):544-53. doi: 10.1053/jhep.2001.22131.Gregorio G. V., Portmann B., Karani J., Harrison P., Donaldson P. T., Vergani D., Mieli-Vergani G. Autoimmune hepatitis/sclerosing cholangitis overlap syndrome in childhood: a 16-year prospective study. Hepatology. 2001 Mar;33(3):544-53. doi: 10.1053/jhep.2001.22131.Beaune P., Dansette P. M., Mansuy D., Kiffel L., Finck M., Amar C., Leroux J. P., Homberg J. C. Human anti-endoplasmic reticulum autoantibodies appearing in a drug-induced hepatitis are directed against a human liver cytochrome P-450 that hydroxylates the drug. Proc Natl Acad Sci U S A. 1987 Jan;84(2):551-5. doi: 10.1073/pnas.84.2.551.Beaune P., Dansette P. M., Mansuy D., Kiffel L., Finck M., Amar C., Leroux J. P., Homberg J. C. Human anti-endoplasmic reticulum autoantibodies appearing in a drug-induced hepatitis are directed against a human liver cytochrome P-450 that hydroxylates the drug. Proc Natl Acad Sci U S A. 1987 Jan;84(2):551-5. doi: 10.1073/pnas.84.2.551.Bourdi M., Larrey D., Nataf J., Bernuau J., Pessayre D., Iwasaki M., Guengerich F. P., Beaune P. H. Anti-liver endoplasmic reticulum autoantibodies are directed against human cytochrome P-450IA2. A specific marker of dihydralazine-induced hepatitis. J Clin Invest. 1990 Jun;85(6):1967-73. doi: 10.1172/JCI114660.Bourdi M., Larrey D., Nataf J., Bernuau J., Pessayre D., Iwasaki M., Guengerich F. P., Beaune P. H. Anti-liver endoplasmic reticulum autoantibodies are directed against human cytochrome P-450IA2. A specific marker of dihydralazine-induced hepatitis. J Clin Invest. 1990 Jun;85(6):1967-73. doi: 10.1172/JCI114660.Muratori P., Granito A., Quarneti C. et al. Autoimmune hepatitis in Italy: the Bologna experience. J Hepatol. 2009 Jun;50(6):1210-8. doi: 10.1016/j.jhep.2009.01.020.Muratori P., Granito A., Quarneti C. et al. Autoimmune hepatitis in Italy: the Bologna experience. J Hepatol. 2009 Jun;50(6):1210-8. doi: 10.1016/j.jhep.2009.01.020.Zachou K., Gatselis N., Papadamou G., Rigopoulou E. I., Dalekos G. N. Mycophenolate for the treatment of autoimmune hepatitis: prospective assessment of its efficacy and safety for induction and maintenance of remission in a large cohort of treatment-naïve patients. J Hepatol. 2011 Sep;55(3):636-646. doi: 10.1016/j.jhep.2010.12.032.Zachou K., Gatselis N., Papadamou G., Rigopoulou E. I., Dalekos G. N. Mycophenolate for the treatment of autoimmune hepatitis: prospective assessment of its efficacy and safety for induction and maintenance of remission in a large cohort of treatment-naïve patients. J Hepatol. 2011 Sep;55(3):636-646. doi: 10.1016/j.jhep.2010.12.032.Obermayer-Straub P., Perheentupa J., Braun S., Kayser A., Barut A., Loges S., Harms A., Dalekos G., Strassburg C. P., Manns M. P. Hepatic autoantigens in patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. Gastroenterology. 2001 Sep;121(3):668-77. doi: 10.1053/gast.2001.27103.Obermayer-Straub P., Perheentupa J., Braun S., Kayser A., Barut A., Loges S., Harms A., Dalekos G., Strassburg C. P., Manns M. P. Hepatic autoantigens in patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. Gastroenterology. 2001 Sep;121(3):668-77. doi: 10.1053/gast.2001.27103.

The authors declare that there are no conflicts of interest present.