Problematic issues of autoimmune hepatitis in children

Recently, autoimmune hepatitis (AIH) is beco-ming more common; as stated in the EASL 2015 recommendation, it can occur in any population and in all age groups. The etiology of AIH is unknown, the pathogenesis is insufficiently studied. Factors that directly trigger the autoimmune process have not been established. They can belong to environmental and infectious agents. Autoimmune hepatitis is heterogeneous in both clinical and serological manifestations, is characterized by a wide range of clinical symptoms of the disease: from asymptomatic to severe course, with or without extrahepatic manifestations, which can affect almost all organs and systems. AIH has a variety of clinical manifestations, it is not a clinically stable process, it should be excluded in all patients with symptoms of liver damage. Own observations of children with AIH with atypical manifestations of the disease are presented. Positive autoantibodies and the use of a pediatric scale are the keys in AIH diagnosis. With the exception of the fulminant course of the disease, AIH responds well to immunosuppressive therapy regardless of the degree of liver dysfunction. In childhood, remission is achieved in 60–90 % of patients depending on the severity of the disease at its manifestation, speed and degree of response to treatment.