Treatment of Autoimmune Hepatitis in Children Under 18 Years

Autoimmune hepatitis in pediatric patients (age <18 years) follows the same overarching treatment principles as in adults, but requires specific adaptations to account for the vulnerabilities of a growing child — particularly regarding corticosteroid-related adverse effects such as growth failure.

Clinical Scenario This protocol applies to children under 18 years of age diagnosed with autoimmune hepatitis. Treatment in this age group is guided by the same evidence base as adult care, with tailored corticosteroid weaning to a low maintenance dose to minimise the risk of growth-related side effects.

Treatment Approach (partial overview) The protocol covers the use of calcineurin inhibitor therapy for cases where the initial treatment approach has not achieved sufficient disease control. This class of agents requires careful monitoring for specific side effects. The complete regimen — including agent selection, monitoring parameters, and sequencing — is in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.jhep.2025.03.017

Treatment of AIH in children should follow the same guidance as in adults except for tailored weaning of predniso(lo)ne to a maintenance dose of 2.5–5 mg/day to avoid corticosteroid-related side effects including growth failure (LoE 2, strong recommendation, strong consensus).

Second- and third-line agents such as MMF and calcineurin inhibitors are recommended for treatment refractory cases with close monitoring for side effects including teratogenicity of MMF (LoE 3, strong recommendation, strong consensus).

View source ↗