Swiss Pediatric Liver Center, Division of Pediatric Specialties, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals Geneva and University of Geneva, Geneva, Switzerland.
Pediatric Hepatology, Gastroenterology and Transplantation, Hospital Papa Giovanni XXIII, Bergamo, Italy.
Anal Biochem. 2022 Apr 15;643:114576. doi: 10.1016/j.ab.2022.114576. Epub 2022 Jan 29.
That children present with hepatic encephalopathy (HE) in the setting of acute liver failure (ALF) is accepted and a recognized prognostic factor for survival [1,2]. What is less understood is the impact of chronic liver disease (CLD) on the neuro-cognitive and -psychiatric development and outcomes of children with chronic liver disease early in life. Much is extrapolated from the adult literature or from work in experimental models. But what distinguishes children is that central nervous system development, characterized by massive brain growth, is ongoing at the time of liver disease, arguably exposing them to unique risks, something which cannot be extrapolated from adults. The purpose of this brief review is to summarize what is distinctive about the neurocognition of children with CLD or having presented CLD or portosystemic bypass in childhood.
儿童在急性肝衰竭（ALF）背景下出现肝性脑病（HE）是公认的、影响生存率的一个预后因素[1,2]。但人们对慢性肝病（CLD）对儿童生命早期慢性肝病的神经认知和精神发育及结局的影响了解较少。这方面的信息大多是从成人文献或实验模型研究中推断出来的。但儿童有其独特之处，他们的中枢神经系统正在发育，大脑快速生长，此时发生肝脏疾病，可能会使他们面临独特的风险，而这些风险无法从成年人身上推断出来。本文简要综述了儿童慢性肝病或儿童期曾出现过 CLD 或门体分流患儿的神经认知方面的独特之处。
