Liver disease in the older child
1Department of Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Queensland, Australia.
Journal of Paediatrics and Child Health
|November 16, 2020
Summary
Pediatric liver disease presents acutely or is found incidentally via abnormal liver tests or portal hypertension complications. Key causes include infections, autoimmune conditions, and non-alcoholic fatty liver disease, requiring specific diagnostic approaches.
Area of Science:
- Pediatric Gastroenterology and Hepatology
Background:
- Liver disease in children manifests in several ways: acute hepatitis, abnormal liver function tests, or portal hypertension complications.
- Acute hepatitis causes include infections, drugs, vascular issues, autoimmune hepatitis, and idiopathic liver failure.
- Non-alcoholic fatty liver disease is the leading cause of abnormal liver function tests in children, though other factors like medications and metabolic diseases are considered.
Purpose of the Study:
- To outline the common presentations and differential diagnoses of pediatric liver disease.
- To highlight key diagnostic indicators and imaging techniques for evaluating liver conditions in children.
Main Methods:
- Review of clinical presentations of pediatric liver disease.
- Discussion of etiological factors for acute and insidious liver disease.
- Explanation of diagnostic markers like international normalised ratio and creatine kinase.
- Role of Doppler ultrasound in assessing portal hypertension.
Main Results:
- Abnormal liver function tests are frequently linked to non-alcoholic fatty liver disease.
- Autoimmune hepatitis and alpha-1-antitrypsin deficiency are common causes of insidious liver disease.
- Specific tests like international normalised ratio and creatine kinase aid in diagnosis and severity assessment.
- Doppler ultrasound is crucial for differentiating extra-hepatic portal hypertension from intrinsic liver disease.
Conclusions:
- Accurate diagnosis of pediatric liver disease relies on recognizing diverse presentations and employing targeted investigations.
- Understanding the differential diagnoses and utilizing specific biomarkers and imaging are essential for effective management.
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