Evaluation of Interlukin 10 Gene Promotor Polymorphism in Children with Acute Hepatitis A Induced Liver Failure

Abstract

Background: Pediatric Acute liver failure (ALF) is a rare but rapidly and frequently mortal condition. A large number of inflammatory markers have been implicated in causing liver injury. The aim of the present study was to assess IL10 level and polymorphism in children with acute viral hepatitis (AVH) and ALF.  Patients and methods: This study included 48 children and carried out at the hepatology Unit, Pediatric Department Zagazig University Children Hospital in co-operation with the scientific and Medical Research Center of the Faculty of Medicine, Zagazig University and the pediatric Department of the National Liver Institute. The studied patients were divided equally into the fulminant hepatitis group and the control group (acute viral hepatitis). Results: There is statistically significant difference between studied groups regarding platelet count, hemoglobin and WBCs, ALT, AST, bilirubin, INR. The best cutoff of serum Il-10 in prediction of FHF is ≥39.5 pg/ml with area under curve 0.998, sensitivity 95.8%, specificity 95.8%, positive predictive value 95.8%, negative predictive value 95.8%, overall accuracy 95.8%.There is statistically significant difference between studied groups regarding IL-10 genotype polymorphism at A-G transition concerning genotype and alleles. C allele significantly increase risk of FHF by 14.44 folds denoting that AA (wild type) genotype protects against the development of fulminant hepatitis.C allele significantly increase risk of FHF by 4.71 folds denoting that TT genotype significantly protects against the development of fulminant liver failure. Conclusion: Regulatory polymorphism in the IL-10 gene promoter has a possible and significant association with the severity and the outcome in patients with AVH and ALF.