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Nonalcoholic steatohepatitis in children
1Division of Gastroenterology and Nutrition, The Hospital for Sick Children, and the University of Toronto, Ontario, Canada.
Journal of Pediatric Gastroenterology and Nutrition
|January 12, 2000
Summary
Nonalcoholic steatohepatitis (NASH) is uncommon in children but presents diverse clinical features. This pediatric liver disease can progress to fibrosis and cirrhosis, indicating it may not be benign.
Area of Science:
- Pediatric Hepatology
- Gastroenterology
- Internal Medicine
Background:
- Nonalcoholic steatohepatitis (NASH) is frequently observed in adults with obesity or diabetes mellitus.
- Reports of NASH in pediatric populations are limited, necessitating further investigation.
Purpose of the Study:
- To investigate the clinical characteristics and outcomes of nonalcoholic steatohepatitis in children.
- To highlight the diagnostic challenges and potential severity of pediatric NASH.
Main Methods:
- A prospective, consecutive clinical series of 36 children diagnosed with NASH between 1985 and 1995.
- Evaluation included clinical assessment, laboratory tests, liver sonograms, and liver biopsies.
Main Results:
- The median age at diagnosis was 12 years, with 83% of patients being obese.
- Elevated serum aminotransferases and abnormal liver sonograms were common findings.
- Liver biopsies revealed steatosis in all patients, with inflammation in 88% and fibrosis/cirrhosis in 75%, including one case of established cirrhosis at diagnosis.
Conclusions:
- Nonalcoholic steatohepatitis occurs in children and presents with a wide range of clinical manifestations.
- Pediatric NASH is not a benign condition and can lead to significant liver damage, including cirrhosis.