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Liver disease in India

S A Bhave, A N Pandit, A M Pradhan

    Archives of Disease in Childhood
    |December 1, 1982
    PubMed
    Summary
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    Indian childhood cirrhosis in children presents insidiously with high hepatic copper. Early diagnosis is crucial, as advanced stages have poor prognosis, highlighting the need for non-invasive diagnostic methods.

    Area of Science:

    • Pediatric Hepatology
    • Gastroenterology
    • Clinical Medicine

    Background:

    • Chronic liver disease in children presents diagnostic challenges.
    • Indian childhood cirrhosis (ICC) is a distinct entity with unique epidemiological features.
    • Understanding ICC's clinical presentation and prognosis is vital for early intervention.

    Purpose of the Study:

    • To characterize the clinical, epidemiological, and pathological features of Indian childhood cirrhosis.
    • To identify prognostic indicators for survival in children with ICC.
    • To underscore the need for early and non-invasive diagnostic tools for ICC.

    Main Methods:

    • Retrospective analysis of 125 children with chronic liver disease over 13 months.
    • Histological diagnosis of Indian childhood cirrhosis in 59 patients (aged 8-39 months).

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  • Assessment of clinical presentation, geographical clustering, familial factors, and hepatic copper levels.

    • Main Results:

    • Fifty-nine children diagnosed with ICC showed insidious onset, rural clustering, parental consanguinity, and extremely high hepatic copper.
    • Only 8 of 59 ICC patients survived 6 months; jaundice, ascites, and anemia were poor prognostic signs.
    • Clinical differentiation was difficult in early ICC stages, emphasizing the need for non-invasive diagnostics.

    Conclusions:

    • Indian childhood cirrhosis is characterized by high hepatic copper and poor outcomes if diagnosed late.
    • Early detection through non-invasive methods is essential for improving survival rates in ICC.
    • Other diagnoses in the cohort included unresolved hepatitis, chronic active hepatitis, cryptogenic cirrhosis, and biliary atresia.