Serological markers of autoimmunity in children with hepatitis A
| Autor: | Tahany Abdel-Hameed Salem, Mostafa Mohamed Sira, Suzan El Naghi, Ahmad Mohamed Sira, Tawhida Y. Abdel-Ghaffar, Ahmed A. El-Sharawy |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Image-Guided Biopsy
Male Adolescent viruses Fulminant Autoimmunity Enzyme-Linked Immunosorbent Assay Autoimmune hepatitis Disease medicine.disease_cause Severity of Illness Index Virus Serology medicine Humans Prospective Studies Child Fulminant hepatitis Autoantibodies Ultrasonography Hepatology business.industry Gastroenterology Infant virus diseases Hepatitis A medicine.disease digestive system diseases Liver Case-Control Studies Child Preschool Acute Disease Immunology Disease Progression Female gamma-Globulins business Biomarkers |
| Zdroj: | European Journal of Gastroenterology & Hepatology. 27:1161-1169 |
| ISSN: | 0954-691X |
| Popis: | Hepatitis A virus (HAV) infection tends to be a self-limiting disease without serious sequelae, but fulminant hepatitis, with a high mortality, develops in 0.1-0.2% of the cases. Sometimes, HAV infection precipitates autoimmune hepatitis (AIH). We aimed to assess the frequency and clinical significance of serologic markers of autoimmunity during hepatitis A infection with an acute or fulminant presentation compared with those in AIH.The study included 126 children: 46 with HAV infection (33 with acute and 13 with fulminant presentation), 53 with AIH, and 27 healthy controls. In all, we measured autoantibodies titer (antinuclear antibody, antismooth muscle antibody, and liver kidney microsomal antibody-1) and serum gammaglobulins.Autoantibodies were detected in the majority of HAV (63.1%) and AIH (79.2%) groups, but in none of the controls. Gammaglobulins were significantly higher in the HAV group (1.93±0.57 g/dl) than in the controls (1.32±0.29 g/dl), but lower than that in the AIH group (2.93±1.2 g/dl) (P0.0001 for all). In the HAV group, gammaglobulins were significantly higher in those with fulminant (2.21±0.46 g/dl) than in those with acute presentation (1.82±0.57 g/dl) (P=0.019), but comparable with that in AIH (P=0.095). Gammaglobulins correlated significantly with disease severity in both HAV and AIH groups.Hypergammaglobulinemia and a high occurrence of autoantibodies are encountered in HAV infection. This may support the immunological basis of its pathogenesis. Moreover, the higher gammaglobulins in fulminant HAV, with an insignificant difference from that in AIH, suggest that a more aggressive immunological reaction is related to this presentation. |
| Databáze: | OpenAIRE |
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