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Prevalence and Significance of Autoantibodies in Children With Acute Liver Failure
| Content Provider | Scilit |
|---|---|
| Author | Narkewicz, Michael R. Horslen, Simon Belle, Steven H. Rudnick, David A. Ng, Vicky L. Rosenthal, Philip Romero, Rene Loomes, Kathleen M. Zhang, Song Hardison, Regina M. Squires, Robert H. |
| Copyright Year | 2017 |
| Description | Journal: Journal of pediatric gastroenterology and nutrition Objectives: The purpose of the present study is to estimate autoantibody (auto-AB) frequency, clinical characteristics, and 21-day outcome of participants in the Pediatric Acute Liver Failure Study Group (PALFSG) by antinuclear antibody, smooth muscle antibody, and liver-kidney microsomal (LKM) antibody status. Methods: Auto-ABs were determined at local and/or central laboratories. Subjects were assigned to autoimmune hepatitis (AIH), indeterminate, and other diagnoses groups. Results: Between 1999 and 2010, 986 subjects were enrolled in the PALFSG. At least 1 auto-AB result was available for 722 (73.2%). At least 1 auto-AB was positive for 202 (28.0%). Diagnoses for auto-AB+ subjects were AIH (63), indeterminate (75), and other (64). Auto-ABs were more common in Wilson disease (12/32, 37.5%) compared with other known diagnoses (52/253, 20.6%, P = 0.03). LKM+ subjects were younger (median 2.4 vs 9.1 years, P < 0.001) and more likely to undergo liver transplantation (53.3% vs 31.4% P = 0.02) than other auto-AB+/LKM− subjects. Steroid treatment of subjects who were auto-AB+ was not significantly associated with survival and the subgroup with known diagnoses other than AIH had a higher risk of death. Conclusions: Auto-ABs are common in children with acute liver failure, occurring in 28%. Auto-AB+ subjects have similar outcomes to auto-AB negative subjects. LKM+ children are younger and more likely to undergo liver transplantation compared with other auto-AB+ subjects. Although auto-AB may indicate a treatable condition, positivity does not eliminate the need for a complete diagnostic evaluation because auto-ABs are present in other conditions. The significance of auto-AB in pediatric acute liver failure remains uncertain, but LKM+ appears to identify a unique population of children who merit further study. |
| Related Links | http://europepmc.org/articles/pmc5250572?pdf=render https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5250572/pdf |
| Ending Page | 217 |
| Page Count | 8 |
| Starting Page | 210 |
| ISSN | 02772116 |
| e-ISSN | 15364801 |
| DOI | 10.1097/mpg.0000000000001363 |
| Journal | Journal of pediatric gastroenterology and nutrition |
| Issue Number | 2 |
| Volume Number | 64 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2017-02-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of pediatric gastroenterology and nutrition Autoantibodies, Pediatric Liver Failure, Pediatric Liver Transplant |
| Content Type | Text |
| Resource Type | Article |
| Subject | Gastroenterology Pediatrics, Perinatology and Child Health |
