Liver Cirrhosis in Children

Abstract

Background :Liver cirrhosis is one of the major causes of hospitalization and mortality in children. A wide spectrum of disorders including developmental abnormalities, infections, metabolic and genetic disorders can lead to liver cirrhosis in pediatric patients. Determination of its etiology is important for treatment, prevention of progressive liver damage, family counseling and prioritizing liver transplantation. The aim of this study is to evaluate etiological and prognostic aspects of liver cirrhosis in children at the pediatrics department at the university hospital center of Marrakech. Methods :We included all cirrhotic children under the age of 15 who were hospitalized in the gastro-pediatric department at the University Hospital Center of Marrakech over a period from January 2012 to December 2018 in this retrospective study. The etiology of cirrhosis was determined based on clinical results, laboratory tests, imaging studies mainly by ultrasound and histopathological examination of the liver biopsy. Results :A total of 78 cirrhotic children aged 1 month to 12 years with an average age of 3 years and 5 months, including 43 boys (55%) and 35 girls (45%) were enrolled in the study. The most common causes of liver cirrhosis were: 20 cases of Wilson's disease, biliary atresia in 16 cases, 5 cases of glycogenosis, 3 cases of PFIC, 2 cases of sclerosing cholangitis, 2 cases of tyrosinemia, 2 cases of alpha 1 antitrypsin deficiency, one case of hepatitis B, one case of autoimmune hepatitis, one case of cirrhosis on celiac disease and one case of hemochromatosis. In 31% of cases, the cause of cirrhosis was unknown. Conclusion :Given the two most common pathologies of cirrhosis of the liver in children in this region of Morocco, we suggest an earlier diagnosis for these two pathologies.