Racial disparities in presentation and outcomes of paediatric autoimmune hepatitis

Liver International : Official Journal of the International Association for the Study of the Liver
Sirish K PalleNitika A Gupta

Abstract

Most studies on autoimmune hepatitis (AIH) in children are in predominantly Caucasian cohorts. Paediatric AIH in African Americans (AA) is understudied, with a dearth of clinical predictors of outcome, often leading to serious complications and even mortality. The aim of the study was to define disease presentation, progression, response to therapy and outcomes in paediatric AIH in a well-defined, large, single centre, demographically diverse population. We conducted a review of patients with AIH who were followed at this tertiary liver transplant centre. Clinical and laboratory covariates were assessed with regard to disease presentation, progression and outcomes in AA vs Non-AA children. African Americans patients constituted 42% of this cohort. At 1-year follow-up, AA children were receiving significantly higher doses of steroids compared to non-AA. More AA presented with end-stage liver disease (ESLD) with high immunoglobulin G and GGT:platelet ratio. After adjusting for other risk factor variables like gender, age at presentation and ESLD, AA children were at 4.5 times higher risk for significant outcome liver transplant/death within the first 12 months of presentation. Post-transplant, recurrent AIH was seen in 50% of AA ...Continue Reading

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Citations

Oct 28, 2019·Journal of Clinical Gastroenterology·Jennifer Y LeeAlan Bonder
Aug 17, 2020·Digestive Diseases and Sciences·Melissa MartinMindie H Nguyen
Dec 22, 2019·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Cara L MackAlbert J Czaja
Feb 2, 2021·Current Gastroenterology Reports·James P StevensNitika Arora Gupta
Dec 5, 2020·Curēus·Ahila ManivannanNabil Al-Kourainy
Jun 1, 2021·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Brian T LeeLily Dara

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