Pediatric Liver Disease
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People often think of cirrhosis as a disease caused by long-term alcohol abuse. While this is sometimes a factor in adults, cirrhosis in children often stems from a wide variety of liver disorders, including but certainly not limited to :.
What are some common liver disease symptoms?
Liver cirrhosis symptoms itself often causes no symptoms early in the disease process. Symptom severity may depend on the extent of liver damage. A person in the early stages of cirrhosis may feel fatigued and weak. Sometimes he or she will experience abdominal swelling that feels tender or painful. Family may notice the person has a poor appetite or is losing weight. As the disease progresses, bile flow is blocked or stopped, and jaundice yellow skin or eyes appears.
The same bile pigment, bilirubin, which is responsible for the yellow skin tones of jaundice can turn urine dark. Bleeding and bruising can occur more easily and take longer to heal. Other later symptoms, some due to complications, include:.
If your child's doctor suspects that your child has cirrhosis, he or she will perform tests to confirm or rule out the diagnosis. Tests may include but are not limited to :. In general, cirrhosis cannot be cured or reversed, doctors treat it with the following goals:. Your child's doctor may prescribe drugs to treat the underlying cause of the liver disease.
Other medications may be used to control symptoms or fight infections. Some medications are prescribed to get rid of excess fluid in the body or reduce the risk of a blood vessel breaking. Others help your child's body cut down on its absorption of harmful waste products or toxins.
Pediatric Liver Disease | Children's Healthcare of Atlanta
If the complications of cirrhosis can no longer be controlled, or if the liver is in danger of no longer functioning, a liver transplant is often the best option. Many of the liver disorders that cause cirrhosis in children are not preventable, but there are precautions you can take. Make sure your child receives all recommended immunizations including influenza and hepatitis vaccines at the times your pediatrician recommends.
If your child needs to take medications that may damage the liver, follow your doctor's recommendations about blood tests.
Balanced nutritional intake is important for people who already have cirrhosis of the liver can prevent or slow further liver damage by following their doctor's instructions regarding diet. Both parents must be carriers of the genetic defect to have a child with A1AT deficiency.
Although carrier parents partially produce the abnormal A1AT protein, they usually have no — or very minimal — symptoms and they may not realize they are partially affected until their child is diagnosed with the condition. About 10 percent of newborns with liver disease will be diagnosed with A1AT deficiency. Newborns may develop jaundice as part of inflammation of the liver associated with A1AT deficiency.
Older children and teens can present with a liver that has been inflamed for a long time, causing scarring cirrhosis to develop. Lung disease usually develops only in adulthood. Adults with A1AT deficiency may have difficulties with chronic obstructive pulmonary disease COPD , emphysema , chronic bronchitis , asthma , coughing and repeated lung infections.
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Testing is usually done when a child has liver inflammation of uncertain cause or when a family history suggests A1AT liver disease. The standard screening test is to measure the amount of A1AT protein in the circulation. When a low A1AT level is found, an additional test is usually done to identify the types of abnormal A1AT proteins that are in the circulation.
In rare cases, a more detailed analysis of the DNA in the gene may be necessary.
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The amount of liver swelling and damage can be assessed by ultrasonography sonogram of the abdomen, blood tests of liver inflammation and function and a liver biopsy, where a small piece of liver tissue is obtained and then examined under the microscope to search for changes typical of A1AT deficiency. There is no cure for A1AT deficiency.
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Therapy involves controlling symptoms and attempting to prevent the development of complications. To protect their lungs, it is very important that the affected person and those around them not smoke. Vaccinations to protect against viruses, such as hepatitis A and hepatitis B, that can further damage the liver should be given. It is difficult to predict how severely a liver will be affected. Liver function tests are followed over time.
Some patients may have minimal liver disease during their entire lifetime; however, a small number will eventually require liver transplant. Cirrhosis or chronic liver failure can be caused by a number of the liver and biliary diseases listed in Clinical Services or sometimes appear without known cause. Our approach to pediatric patients with this problem is to start with a thorough history and physical examination and nutritional assessment.