For a study, researchers sought to assess the long-term development of children and adolescents with autoimmune liver disease (AILD) who were receiving daily steroid treatment.
The study was a retrospective observational cohort study of kids under the age of 16 who received a diagnosis between 1992 and 2004. At diagnosis, 1 and 5 years after starting therapy, and at age 18, growth measures (height, weight, and body mass index, or BMI), converted to z-scores, were collected and examined together with demographics, disease- and treatment-related features.
At a median age of 12.85 years (interquartile range (IQR) 9.44, 14.14), for a median length of 12.07 years (IQR 8.68, 13.97), 74 patients (35 female) began receiving therapy. The mean z-scores for weight, height, and BMI were consistently within the normal range at all time periods, indicating appropriate nutritional status. When comparing gender (male vs. female), ethnicity (Caucasian vs. non-Caucasian), diagnosis (AIH vs. ASC), and presence of IBD (n=23), there was no difference in the change in z-score for weight, height, and BMI from diagnosis until age 18 years. The difference in z-score between the groups of children under 12 and those over 12 was less for height and weight (P<0.05 and P<0.05, respectively). Additionally, there was a positive correlation between the change in height z-score and age at the beginning of steroid therapy (r=0.321, P< 0.05) and a negative correlation between the length of steroid treatment (r=-0.321, P<0.05).
During long-term follow-up, the growth of patients with AILD receiving a daily maintenance dosage of steroids remained steady and within the normal range. The effectiveness of small, daily dosages in maintaining disease control reduces the necessity for high-dose steroid pulses during relapses.