Chronic Liver Diseases in Children: Clinical Spectrum and Etiology

Objectives: To study the magnitude of chronic liver disorders in children attending the only tertiary care hospital. To study the spectrum of chronic liver disorders in children. Study design: Prospective observational study Material and methods: The study included prospective (July 2007 to Dec.2008) analysis of all children < 18 yrs with chronic liver disorders. A total of 94 children with confirmed diagnosis of chronic liver disease were included in the study. The diagnosis of all liver diseases was based on established clinical and diagnostic criteria. Severity of chronic liver disease was defined using Child grading. Results: Mean age of patients was 10.4 ± 4 yrs with a range of 1-18 yrs. Jaundice(75%), ascites (64%),encephalopathy (29%) were presenting symptoms in chronic liver disease patients indicating decompensation at presentation .Features of portal hypertension were seen in 65%.Etiology was found to be HBV in 18%, Wilsons disease in 16% ,HCV in 6.4%, autoimmune in 5.3% and alpha-1 antitrypsin deficiency in 1.1% and no etiology could be found in 52%(cryptogenic) .In acute liver diseases HAV was cause in 43%, HBV in 27% and HEV in 7% cases. Conclusion: Chronic liver diseases in our set up are mainly constituted by post hepatitic, metabolic and cryptogenic etiology .Lack of advanced biochemical and specific diagnostic tools resulted in high percentage of cryptogenic cirrhosis our study.

Author(s): Gulzar Ahmad Dar, Mohammad Ishaq Malik, Farooq Ahmad Ganie, Kowsar Jan, Tariq Abdullah, Mohd Iqbal Dar1 and Maqsood Ahmad Dar

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