The current state of the problem of seronegative autoimmune hepatitis in children
https://doi.org/10.31146/1682-8658-ecg-221-1-5-12
Abstract
Seronegative autoimmune hepatitis (AIH) is a poorly understood problem in both adult patients and children. The key to the diagnosis of AIH is the presence of circulating autoantibodies, which are not detected in seronegative AIH. There is insufficient data on the contribution of autoantibodies to hepatocyte damage in seronegative AIH. The presence of plasma cells in liver biopsies of patients with seronegative AIH suggests that its pathogenesis involves physiopathological mechanisms similar to those of seropositive AIH. Unlike adults, in whom acute manifestations of the disease are rare, in children’s acute manifestations of seronegative AIH were observed in three quarters of patients. In addition to the absence of autoantibodies, the diagnosis is complicated by the low level of gammaglobulins in the blood in seronegative AIH. In seronegative AIH, hepatitis-associated aplastic anemia often develops. Morphological examination of liver biopsies may reveal infiltration with a predominance of CD8+ T cells. Treatment of seronegative AIH includes immunosuppressive therapy, as for seropositive AIH. The prognosis for seronegative AIH is usually favorable. Although seronegative autoimmune hepatitis is not uncommon, little is known about its diagnosis and treatment.
About the Authors
G. V. Volynets
Scientific Research Clinical Institute of Pediatrics and Pediatric Surgery named after Academician Yu.E. Veltishchev Federal State Autonomous Educational Institution of Russian National Research Medical University named after. N.I. Pirogov Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
A. S. Potapov
National Medical Research Centre for Children’s Health; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
A. I. Khavkin
Research Clinical Institute of Childhood, Ministry of Health of the Moscow Region
Russian Federation
Russian Federation
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Review
For citations:
Volynets G.V., Potapov A.S., Khavkin A.I. The current state of the problem of seronegative autoimmune hepatitis in children. Experimental and Clinical Gastroenterology. 2024;(1):5-12. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-221-1-5-12
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