Clinical presentations and histopathological types of chronic liver disease in paediatric population

Objective: To determine the frequency of different clinical presentations and histopathological type of chronic liver disease (CLD) in children. Material and Methods: This descriptive, cross-sectional study was conducted at the Department of Pediatric Medicine, Combined Military Hospital Kharian, Pakistan from 1st January 2018 to 31st December 2018. A total of 80 children presenting with CLD with age 1-15 years of either gender, were included in study. Patients with any hepatotoxic drug intake or CRF were excluded. After informed written consent from parents, clinical presentation like ascites, jaundice and encephalopathy of CLD was noted. Corresponding raised serum bilirubin was checked and following an ultrasound abdomen for liver, histo-pathological evidence of type of CLD was confirmed on liver biopsy in each case. Results: Mean age for patients was 7.56 ± 4.65 years. Out of the 80 patients, 49 (61.25%) were male and 31 (38.75%) were females, with male to female ratio of 1.6:1. Jaundice was present in 63 (78.75%) patients (with corresponding serum bilirubin >2 g/dL), ascites in 45 (56.25%) and encephalopathy in 19 (23.75%) patients. Liver biopsy was consistent with CLD in each case. Chronic hepatitis was identified in 53.8%, followed by Biliary pathway associated CLD in 16.3% and Wilson's disease in 13.8%. Conclusion: This study concluded that chronic hepatitis is most common histopathological pattern and jaundice is the most common clinical presentation in children with CLD, followed by ascites and encephalopathy. (author)