CHRONIC ACTIVE HEPATITIS IN CHILDREN A Clinical and Immunological Long‐term Study

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Abstract
Six girls and 1 boy with chronic active hepatitis (CAH) of unknown etiology were between 9 and 15 yr at the clinical onset of their illness. After beginning immunosuppressive therapy the course of their disease was followed from 1 to 10 yr. All had markedly increased IgG [immunoglobulin G], high titers of smooth muscle antibodies (SMA) and antinuclear antibodies of the IgG class in the earliest serum specimens tested. Therapy resulted in an improved sense of well-being and a decrease in SGOT [serum glutamic oxaloacetic transaminase], IgG and titers of SMA. Very high titers of measles antibodies were observed in all cases. In 1 case CAH manifested itself after measles and in another after rubella infection. The 1st case in this series of patients died of liver failure after 5 yr of illness. The other patients have survived and are able to live a normal life. The possibility of CAH should be considered when children develop symptoms of hepatitis. Long-term immunosuppressive treatment with regular clinical and laboratory evaluation is important. Estimation of titers of SMA is an additional parameter of value in following of the activity of CAH in these young patients.