ETIOLOGICAL PROFILE OF CHRONIC LIVER DISEASE IN CHILDREN: EXPERIENCE FROM A TERTIARY CARE HOSPITAL
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Keywords
Chronic liver disease, children, biliary atresia, glycogen storage disease, Wilson’s disease, PFIC, autoimmune hepatitis, pediatric hepatology
Abstract
: Chronic liver disease (CLD) in children comprises a diverse group of disorders with varied etiologies, clinical presentations, and outcomes. Early identification of the underlying cause is essential for timely interventions and improving prognosis, particularly in resource-limited settings where advanced diagnostics and liver transplantation facilities may be delayed or inaccessible.
Aim: To assess the clinical profile, etiological spectrum, and outcomes of pediatric patients admitted with chronic liver disease in a tertiary care hospital in Kashmir.
Methods: This was a prospective observational study conducted over two years in the Department of Pediatrics at G.B. Pant Hospital, Government Medical College Srinagar. A total of 44 children aged 1 to 18 years with confirmed or suspected chronic liver disease were enrolled. Detailed history, clinical examination, laboratory investigations, imaging, liver biopsy (where indicated), and genetic analysis were performed. Data were compiled and analyzed using Epi Info software.
Results: Among the 44 children, 59% were males and 41% females, with the majority (70.4%) aged 1–5 years. Abdominal distension (93%) and jaundice (81.8%) were the most common presenting symptoms, while hepatomegaly (77%) and jaundice (79.5%) were the most prevalent signs. Biochemical abnormalities included elevated SGPT/SGOT, hyperbilirubinemia, and prolonged prothrombin time in most patients. The most common etiologies identified were post-Kasai biliary atresia (18.1%), glycogen storage disorders (13.6%), Wilson’s disease (9%), PFIC (9%), and autoimmune hepatitis (6.8%). Genetic abnormalities such as hereditary fructose intolerance, Niemann-Pick disease, and Alagille syndrome were also identified. Liver biopsy was performed in 31% of patients. Four patients (9%) had cryptogenic CLD. Many children presented late, with complications including ascites and variceal bleeding; 18% had previously failed Kasai surgery and were referred for liver transplantation.
Conclusion: Chronic liver disease in children presents with a wide range of clinical and biochemical findings. Biliary atresia remains the leading cause in this setting, followed by metabolic and genetic disorders. Delayed referral and limited access to liver transplantation remain major challenges. Early diagnosis, comprehensive evaluation, and timely surgical or transplant interventions are critical to improving outcomes in pediatric CLD.
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Dr Parvaiz Rafieq sohil
Senior Resident, Department of pediatrics , Government Medical College Srinagar, India
Dr Shaista Ahmad
Senior Resident, Department of pediatrics , Government Medical College Srinagar, India
Dr Jafar Ahmad Tantray
Senior Resident, Department of pediatrics , Government Medical College Srinagar, India
Dr Sourabh Gupta
Postgraduate Scholar, Department of pediatrics , Government Medical College Srinagar, India
Dr Muzafar jan
Professor & Head, Department of pediatrics , Government Medical College Srinagar, India