LABORATORY CRITERIA FOR IMPROVING THE DIAGNOSIS OF AUTOIMMUNE HEPATITIS AND WILSON'S DISEASE IN CHILDREN



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Abstract

The definition of laboratory criteria for improving the differential diagnosis of children with autoimmune hepatitis (AIH) and Wilson's disease (WD) is relevant in pediatrics. One of the criteria for the diagnosis of AIH is an increase in the titers of the antinuclear factor (ANF) in the blood serum. Cases have been described when WD can clinically occur as autoimmune hepatitis (AIH) with the detection of non-specific autoantibodies, which complicates differential diagnosis. The aim of the study was to identify the features of the determination of antinuclear factor on the Hep–2 cell line and specific autoantibodies using a triple substrate in children with autoimmune hepatitis and WD. Materials and methods: 62 children with WD and 28 children with AIH were examined. ANF was determined on the HEp-2 cell line (ANA-HEp-2, AESKUSLIDES®, Germany) and specific autoantibodies using a triple substrate obtained from rodents, which includes samples of kidney, liver and stomach tissues (LKS Mouse, Germany) using indirect fluorescence reactions using an automatic analyzer HELIOS® (Germany). Results: The analysis revealed positive results of the ANF study in 15 out of 62 (24%) children with WD. Positive ANF results were obtained in 26 out of 28 children(93%) with AIH, significantly more often ANF is detected in children with AIH compared with WD. The study of specific autoantibodies using a triple substrate revealed positive results in 34 children with WD (55%) and 26 children with AIH (93%), significantly more often specific autoantibodies on the triple substrate are detected in children with AIH(p<0.001) than in children with WD. Conclusion: when examining a child with suspected AIH, when a homogeneous type of luminescence is detected on the HEp-2 cell line and with a combination of different types of luminescence on a triple substrate, the presence of WD in patients cannot be excluded.

About the authors

Anastasia A. Zhuzhula

FSAU "NMIC of Children's Health" of the Ministry of Health of the Russian Federation

Email: Anas-zh@inbox.ru
ORCID iD: 0000-0002-6292-7229
SPIN-code: 8783-9571
Scopus Author ID: 57226395657
ResearcherId: AGU-5991-2022

Junior Researcher at the Laboratory of Experimental Immunology and Virology

Russian Federation, 2 Lomonosovsky Ave, Bldg 1Moscow 119991

Olga V. Kurbatova

FSAU "NMIC of Children's Health" of the Ministry of Health of the Russian Federation

Email: putintseva@mail.ru
ORCID iD: 0000-0002-9213-5281

Ph.D. (Medicine), Senior Researcher, Laboratory of Experimental Immunology and Virology

Russian Federation, 2/1, Lomonosov Ave, Moscow, 119296

S. V. Petrichuk

FSAU "NMIC of Children's Health" of the Ministry of Health of the Russian Federation

Email: cito@list.ru
ORCID iD: 0000-0003-0896-6996

PhD, MD (Biology), Professor, Chief Research Associate, Laboratory of Experimental Immunology and Virology

Russian Federation, 2/1, Lomonosovsky prospect., Moscow, 119296

A. P. Fisenko

FSAU "NMIC of Children's Health" of the Ministry of Health of the Russian Federation

Email: Putintseva@mail.ru

PhD, MD (Medicine), Professor, Head

Russian Federation, Moscow

Marina A. Snovskaya

FSAU "NMIC of Children's Health" of the Ministry of Health of the Russian Federation

Email: snows@inbox.ru
ORCID iD: 0000-0002-5263-6743
SPIN-code: 9899-1095
Scopus Author ID: 56515506400

Ph.D. (Medicine), Senior Researcher at the Laboratory of Experimental Immunology and Virology

Russian Federation, 2 Lomonosovsky Ave, Bldg 1Moscow 119991

Goar B. Movsisyan

FSAU "NMIC of Children's Health" of the Ministry of Health of the Russian Federation

Email: movsisyan@nczd.ru
ORCID iD: 0000-0003-2881-4703

Senior Researcher of the Laboratory of Rare Hereditary Diseases, Gastroenterologist of the Gastroenterology Department with the Hepatological Group

Russian Federation, 2/1 Lomonosovsky Ave, Moscow, 119991

Alexander S. Potapov

FSAU "NMIC of Children's Health" of the Ministry of Health of the Russian Federation;
Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: potapov@nczd.ru
ORCID iD: 0000-0003-4905-2373

PhD, MD (Medicine), Professor, Chief Research Associate, Laboratory of Scientific Foundations of Pediatric Gastroenterology and Hepatology, Head of the Center for Inflammatory Bowel Diseases in Children, Head of Gastroenterology Department with Hepatology Group, National Medical Research Center for Children’s Health, Professor, Department of Pediatrics and Pediatric Rheumatology

Russian Federation, 1/2, Lomonosovskiy Pr-t, Moscow, 119991; 8/2, st. Trubetskaya, Moscow, 119991

Elena L. Semikina

FSAU "NMIC of Children's Health" of the Ministry of Health of the Russian Federation;
Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Author for correspondence.
Email: semikinaelena@yandex.ru
ORCID iD: 0000-0001-8923-4652

PhD, MD (Medicine), Professor, Chief Research Associate, Laboratory of Research in Pediatric Gastroenterology and Hepatology, Head of Gastroenterology Department with Hepatology Group, Professor, Department of Pediatrics and Pediatric Rheumatology

Russian Federation, 2/1 Lomonosovsky Ave, Moscow, 119991; 8/2, st. Trubetskaya, Moscow, 119991

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Copyright (c) Zhuzhula A.A., Kurbatova O.V., Petrichuk S.V., Fisenko A.P., Snovskaya M.A., Movsisyan G.B., Potapov A.S., Semikina E.L.

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