The Canadian experience on pediatric liver disease: Early diagnosis is critical

Posted on Monday, October 19, 2015

A first-of-its-kind national study on pediatric Autoimmune Hepatitis (AIH), a progressive inflammatory liver disease, was released today in the esteemed journal, Pediatrics.

Under the leadership of researchers from the Children's Hospital of Eastern Ontario (CHEO), and with the participation of researchers from 13 pediatric centers across Canada, the research team conducted a 10-year retrospective chart review to determine the incidence of AIH, how patients presented with the disease, differences in the type and dosage of medication used to treat AIH across Canada, and differences in patient outcomes. The review also discussed new tests to diagnose AIH, including an MRI scan and blood test.

“Before now, there was little data on the incidence and prevalence of AIH in Canada, and even the worldwide literature is scarce,” said Dr. Carolina Jimenez, who is the lead author, an assistant professor at the University of Ottawa and director of Liver Services Gastroenterology, Hepatology and Clinical Nutrition at CHEO. “Liver disease is not just an adult problem. Our hope is to equip family physicians and specialists alike with evidence-based data so they can start investigations and refer patients earlier; this way, kids get treated faster and will have better outcomes,” she said.

The team studied 159 children with AIH under the age of 18, which corresponds to 2.3 children per million in Canada. Although this disease is relatively rare, the incidence of AIH is higher in the eastern provinces. Fatigue, jaundice, and abdominal pain were the most common symptoms. The review also found that diagnosing AIH usually takes a long time, during which the child's symptoms can worsen.

“Our paper underscores the importance of recognizing and treating this disease early,” said Dr. Fernando Alvarez, a researcher at Montreal's Sainte-Justine Hospital, and professor of pediatrics at the Université de Montréal.  “We can do more for this population of very sick children if we aim to standardize care across Canada. Access to this type of information is a step in the right direction.”

One quarter of children with AIH have a family history of autoimmune disease. Twenty percent of all children with AIH presented with liver damage from the onset, which reflects the chronic nature of the disease and the time required to confirm the diagnosis. Fortunately, children responded well to conventional therapy, which reduces the requirement for a liver transplant.

About the CHEO Research Institute

The CHEO Research Institute coordinates the research activities of the Children's Hospital of Eastern Ontario (CHEO) and is affiliated with the University of Ottawa. Its three programs of research include molecular biomedicine, health information technology, and evidence to practice research. Key themes include cancer, diabetes, obesity, mental health, emergency medicine, musculoskeletal health, electronic health information and privacy, and genetics of rare disease. The CHEO Research Institute makes discoveries today for healthier kids tomorrow. For more information, visit or @CHEOhospital

About the University of Ottawa

The University of Ottawa is committed to research excellence and encourages an interdisciplinary approach to knowledge creation, which attracts the best academic talent from across Canada and around the world. The University is an important stakeholder in the National Capital Region's economic development.

Media inquiries

Adrienne Vienneau
CHEO Research Institute
Office: 613-737-7600 x4144
Cell: 613-513-8437

Danika Gagnon
University of Ottawa
Office: 613-562-5800 x2981
Cell: 613-863-7221

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