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Obese children with steatohepatitis can develop cirrhosis in childhood
Jean P Molleston1, Frances White, Jeffrey Teckman
1Division of Pediatric Gastroenterology/Hepatology/Nutrition, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis 46202-5225, USA.
Insights
Nonalcoholic steatohepatitis (NASH) is rising in obese children. This study reports rare cases of NASH-induced cirrhosis in two boys, with one progressing rapidly to portal hypertension.
Area of Science:
- Hepatology
- Pediatric Gastroenterology
- Obesity Medicine
Background:
- Nonalcoholic steatohepatitis (NASH) is increasingly diagnosed in obese children.
- While liver fibrosis is common in pediatric NASH, cirrhosis is seldom reported.
- The pathogenesis and progression of NASH in pediatric populations require further investigation.
Observation:
- This report details two male pediatric patients who developed cirrhosis secondary to NASH.
- The patients were diagnosed with NASH-induced cirrhosis at ages 10 and 14 years.
- One patient experienced rapid progression to cirrhosis with symptomatic portal hypertension over a two-year period.
Findings:
- NASH can progress to cirrhosis in children and adolescents.
- Early recognition and monitoring of NASH in obese children are crucial.
- The potential for rapid progression to advanced liver disease exists.
Implications:
- Highlights the risk of severe liver disease, including cirrhosis and portal hypertension, in pediatric NASH.
- Underscores the need for vigilant screening and management strategies for NASH in obese children.
- Suggests that pediatric NASH may follow a more aggressive course than previously recognized in some cases.
Abstract:
Nonalcoholic steatohepatitis, in which fatty change and inflammation of the liver occur in the absence of excess alcohol intake, is increasingly recognized in obese children. Although fibrosis is common in pediatric nonalcoholic steatohepatitis, cirrhosis has been reported rarely. The two boys reported here developed cirrhosis from nonalcoholic steatohepatitis at ages 10 and 14 yr. One child progressed to cirrhosis with symptomatic portal hypertension within a 2-yr period.