Etiology and clinical pattern of liver diseases in children

Abstract

Background: liver diseases may not be recognized by clinicians, who can lead to a subsequent delay
in the initiation of effective therapies, the commonest presenting signs and symptoms of pediatric liver
diseases include hepatomegaly, jaundice, coagulopathy or elevation of the liver enzymes or waste
products as ammonia.
Objectives: To highlight the etiologies, pattern of presentations and the route of diagnosis of all liver
diseases in children less than 10 years referred to the Gastroenterology and Hepatology Unit in
Children Welfare Teaching Hospital over a six months period.
Patients and methods: A prospective study was conducted in the Gastroenterology and Hepatology
Unit in the Children Welfare Teaching Hospital / Baghdad Medical City hospital during the period
from first of December 2016 to the end of thirty first of May 2017.
Forty patients aged below 10 years were thoroughly assessed for possible causes of liver disease and
the severity of liver damage. These patients were subjected to a detailed history, thorough physical
examination and a list of investigations
Results: forty patients their age less than 10 years, the most common age group in this study was from
1 year to 5 years was 17(40%), males are more affected than females in the ratio of 1.5:1, it was found
that the mean age of onset is the biliary atresia and Galactosemia cases were within the first week of
life, congenital infection cases presented earlier than the two above groups. In this study most of the
cases were diagnosed clinically and by available investigations and only cases of biliary atresia and
glycogen storage diseases were diagnosed by liver biopsy.
Conclusion: All patients presented late with complications, biliary atresia cases were very late in
presentation, all with fibrosis. Family history usually very important in hereditary liver diseases as
galactosemia and glycogen storage disease a careful physical examination in addition to previous
medical history most of the time gives a clue to the final diagnosis.