Epidemiology and Laboratory Investigations in Children with Chronic Liver Diseases in Sohag University Hospital

Background: Chronic liver diseases encompasse metabolic, genetic, drug-induced and inflammatory diseases. The causes of liver disease in children vary with age. In countries where HBV is endemic, perinatal transmission remains the most important cause of chronic infection. The prevalence of hepatitis C infection was much higher in individuals receiving blood products for conditions such as thalassemia or haemophilia. Glycogen storage disorders may present with chronic liver disease.Objectives: To study epidemiological features and laboratory investigations that may affect the incidence in children with chronic liver disease.Patients and methods: Our study included 30 treatment-naïve patients with chronic liver disease of different aetiologies referred to the Department of Pediatrics, Sohag University Hospital. All patients were subjected to history taking, general and local examinations, laboratory investigations and measurement of serum ceruloplasmin.Results: The mean age of children was 10.23 years in case group and 10.75 years in control group, ranging between 5.5 to 15 years. The majority of patients were females (53.3%) and the remained patients were males (46.7%). There was significant difference between patient and control groups as regard total leucocytic count. Also, there were significant differences between the two groups regarding ALT, AST, total bilirubin, direct bilirubin and concentration and high significant differences regarding serum albumin and prothrombin time.Conclusion: Total leucocytic count, AST, ALT, bilirubin, and serum albumin concentration, and prothrombin time are significant investigations to rule out diagnosis and anticipate complications in patients with chronic liver diseases. ALT and PT are early sensitive markers that anticipate liver decompensation

Role of Ultrasonic Elastography in the Evaluation of Fibrosis in Children with Chronic Liver Disease in Comparison to Liver Biopsy

Background: Chronic liver illnesses can be caused by a variety of factors, including metabolic, genetic, drug-induced, inflammatory, structural, dietary, and immunological factors. Even with Computed Tomography (CT) scans or Magnetic Resonance Imaging (MRI), liver fibrosis makes diagnostic imaging difficult in chronic liver injury. Percutaneous liver biopsy is the gold standard for diagnosing, grading, and monitoring liver fibrosis in children, but it is painful, invasive, requires heavy sedation, and has numerous complications such as bleeding. Objectives: The aim of the current work was to assess and measure liver stiffness in children with chronic liver disease using real-time elastography (RTE), compare the results to histopathological findings obtained after performing a percutaneous liver biopsy, and investigate the availability of noninvasive safe liver elastography as a future replacement for this invasive tool in the evaluation and grading of liver fibrosis.Patients and methods: This hospital-based cross-sectional comparative study included a total of 30 individuals with chronic liver disease of various etiologies with age ranged from 4-16 years, attending at Department of Pediatric, Sohag University Hospitals. This study was conducted between January 2017 to December 2019. A control group of ten healthy people was also included in the investigation.Results: The degree of liver stiffness measured by the last ultrasonic elastography was greater in the patient group than in the control group, with a statistically significant difference between the two groups. Except for F0-F1 and F3-F4, there was a substantial relationship between fibrosis stage and liver stiffness assessment by sonoelastography, where the difference was significant between every two individual groups. There was a strong link between biopsy diagnosis and liver stiffness measurement.Conclusion: It could be concluded that in adults, ultrasonic elastography is a well-established approach for assessing liver fibrosis. The utility of elastography in the follow-up of children with chronic liver disease might be increased