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Incidence of cirrhosis in children with chronic hepatitis
P Vajro1, P Hadchouel, M Hadchouel
1Unité de Recherche d'Hépatologie Pédiatrique, INSERM U 56, Bicêtre, France.
Insights
Children with chronic hepatitis, particularly autoimmune hepatitis, have a high incidence of liver cirrhosis. Cirrhosis can develop early in pediatric liver disease, underscoring the need for accurate diagnostic methods.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Clinical Medicine
Background:
- Chronic hepatitis in children poses a significant risk for developing liver cirrhosis.
- Early diagnosis and intervention are crucial for managing pediatric liver disease progression.
Purpose of the Study:
- To determine the incidence of liver cirrhosis in pediatric patients with chronic hepatitis.
- To evaluate the diagnostic accuracy of laparoscopy combined with needle liver biopsy for cirrhosis in children.
Main Methods:
- A cohort of 92 children with chronic hepatitis was studied between 1975 and 1985.
- Diagnosis of cirrhosis was established using laparoscopy and/or needle liver biopsy.
- Patients were categorized into hepatitis B virus-related chronic hepatitis and autoimmune hepatitis groups.
Main Results:
- Cirrhosis was present in 32% of children with hepatitis B virus-related chronic hepatitis and 89% with autoimmune hepatitis.
- Cirrhosis was diagnosed early, within months of disease onset in some cases.
- Combined laparoscopy and biopsy demonstrated higher reliability for diagnosing cirrhosis than biopsy alone.
Conclusions:
- The incidence of liver cirrhosis is notably high in children with chronic hepatitis, especially autoimmune hepatitis.
- Cirrhosis can develop rapidly in pediatric liver disease, irrespective of the underlying cause.
- Combined laparoscopy and liver biopsy improve diagnostic accuracy for pediatric liver cirrhosis.
Abstract:
To determine the incidence of liver cirrhosis in children with chronic hepatitis, we investigated 92 children (64 were girls; mean age was 8 years 2 months) with chronic hepatitis for the presence of cirrhosis by the combined use of laparoscopy and needle liver biopsy, between 1975 and 1985. Forty-six children had hepatitis B virus-related chronic hepatitis; cirrhosis was present in 13 (32%). Cirrhosis was diagnosed by laparoscopy in 14 children and by needle liver biopsy in eight. In six patients, cirrhosis was diagnosed within the first 12 months after the clinical onset of liver disease. Forty-six children had autoimmune hepatitis; cirrhosis was present in 41 (89%). Cirrhosis was diagnosed by laparoscopy in all 41 children and by needle liver biopsy in 23 children. Cirrhosis was already present in all 10 children studied 2 to 5 months after the first sign of liver disease. Our results indicate that the incidence of cirrhosis is high in children with chronic hepatitis, especially of the autoimmune type, and that cirrhosis may occur early, irrespective of cause. A combination of laparoscopy and biopsy is more reliable than biopsy alone for the diagnosis of cirrhosis in children with chronic hepatitis.