Public Release: 

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

Children's Hospital of Eastern Ontario Research Institute

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

Led from the Children's Hospital of Eastern Ontario (CHEO) including 13 pediatric academic centers across Canada, the research team conducted a retrospective chart review spanning 10 years to unveil: the incidence of AIH; how patients present with the disease; variances in treatment across Canada; and patient outcomes.

"Before now, there was little data on incidence and prevalence of AIH in Canada and even the worldwide literature is scarce," said Dr. Carolina Jimenez, lead author, and director of Liver Services Gastroenterology, Hepatology and Clinical Nutrition at CHEO, and assistant professor at the University of Ottawa. "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."

The team found 159 children under 18 years old with AIH, which represents 2.3 per million in Canada. Although not a common disease, its incidence is higher in the eastern provinces. Fatigue, jaundice, and abdominal pain were the most common presenting symptoms. The review also found that is takes a long time to diagnose AIH, during which time a child's symptoms can get worse.

"Our paper underscores the importance of recognizing and treating this disease early," said Dr. Fernando Alvarez, professor of Pediatrics, Sainte-Justine Hospital, University of Montreal. "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 diseases. 20% of all children presented with cirrhosis from the onset, which reflects chronicity of the disease and the time it takes to confirm the diagnosis, but responded well to conventional therapy -- diminishing the need for a liver transplant.

The review also unveils new tests for diagnosing AIH, including a MRI and blood test. There are variances in the types and dosage of medicines used to treat AIH across Canada too.


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.

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