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Etiology of cirrhosis in the young

Maria C Olave1, Ananta Gurung2, Pramod K Mistry3

  • 1Yale University School of Medicine, Department of Pathology, New Haven, CT 06511, United States.

Human Pathology
|November 8, 2019
PubMed

Insights

Cirrhosis causes differ by age: congenital and developmental disorders in children, and viral hepatitis in young adults. Cryptogenic cirrhosis incidence also varies across pediatric age groups.

Area of Science:

  • Hepatology
  • Pediatric Gastroenterology
  • Internal Medicine

Background:

  • Cirrhosis etiology is well-documented in adults but understudied in younger populations.
  • Understanding pediatric cirrhosis causes is crucial for timely diagnosis and management.

Purpose of the Study:

  • To investigate the diverse causes of cirrhosis in patients aged 40 years and younger.
  • To analyze etiological differences across pediatric and young adult age strata.

Main Methods:

  • Multi-institutional retrospective study of pathology databases (1995-2018).
  • Review of clinical charts and pathology reports for 594 patients ≤40 years old.
  • Stratification into four age groups: <1, 1-<5, 5-<18, and 18-40 years.

Main Results:

  • In patients <18 years, congenital cholestatic/developmental disorders (50.2%) and metabolic/genetic diseases (16.6%) were primary causes.
  • In patients 18-40 years, viral hepatitis (39.6%), autoimmune liver disease (22.2%), and fatty liver disease (15.07%) predominated.
  • Cryptogenic cirrhosis varied by age, lowest in 1-<5 years (1.4%) and highest in 5-<18 years (10.7%).

Conclusions:

  • Cirrhosis etiology in individuals ≤40 years is age-dependent.
  • Congenital and metabolic disorders are key in children, while viral hepatitis dominates in young adults.
  • Age-specific etiological analysis is vital for understanding and addressing cirrhosis in younger demographics.

Keywords:
CirrhosisCryptogenic CirrhosisEpidemiologyEtiologyYoung Adults

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