Sardar Ayesha, Parkash Arit, Merchant Ayesha A, Qamar Bushra, Ayub Faryal, Zehravi Shamama
Pediatric Medicine, National Institute of Child Health, Karachi, PAK.
Cureus. 2022 Jun 1;14(6):e25570. doi: 10.7759/cureus.25570. eCollection 2022 Jun.
Background Chronic liver disease (CLD) is one of the most significant causes of morbidity and mortality among the pediatric age group. The identification of the etiology of the disease is of utmost importance for the effective management of the disease. Objective To determine the various causes of CLD in pediatric patients attending a large public sector pediatric hospital. Patients and methods A prospective cross-sectional study was conducted at the National Institute of Child Health, Karachi, Pakistan from August 1, 2021, to February 28, 2022. All patients below 16 years of age of either gender with more than three months of symptoms duration on admission were enrolled. The diagnosis was labeled after the standard reference ranges for the pediatric age group. Results Of 136 patients, the mean age was 4.42 ± 3.92 years. More than half of the patients were males (76, 55.9%). Hepatitis B (31, 22.8%), idiopathic (23, 16.9%), glycogen storage disorder (GSD) (21, 15.4%), and Wilson disease (14, 10.3%) were the most common cause of CLD. A significant association of hepatitis was observed with age (p-value < 0.001), residence (p-value = 0.048), symptomatic (p-value < 0.001), total bilirubin level (p-value = 0.003), direct bilirubin level (p-value = 0.002), and albumin level (p-value = 0.003). Whereas a significant association of GSD was observed with age (p-value = 0.001), residence (p-value < 0.001), and serum glutamic pyruvic transaminase (SGPT) level (p-value = 0.033). Conclusion In our cohort, hepatitis B, idiopathic, GSD, and Wilson disease were the most common causes of CLD in pediatric patients. Moreover, age, residence, symptomatic, total bilirubin level, direct bilirubin level, SGPT, and albumin level were the important predictor variables.
背景 慢性肝病（CLD）是儿童年龄组发病和死亡的最重要原因之一。确定该疾病的病因对于有效管理该疾病至关重要。目的 确定在一家大型公立儿科医院就诊的儿科患者中CLD的各种病因。患者与方法 2021年8月1日至2022年2月28日在巴基斯坦卡拉奇国家儿童健康研究所进行了一项前瞻性横断面研究。纳入所有16岁以下、入院时症状持续超过三个月的男女患者。根据儿科年龄组的标准参考范围进行诊断。结果 在136例患者中，平均年龄为4.42±3.92岁。超过一半的患者为男性（76例，55.9%）。乙型肝炎（31例，22.8%）、特发性（23例，16.9%）、糖原贮积病（GSD）（21例，15.4%）和威尔逊病（14例，10.3%）是CLD最常见的病因。观察到肝炎与年龄（p值<0.001）、居住地（p值=0.048）、症状（p值<0.001）、总胆红素水平（p值=0.003）、直接胆红素水平（p值=0.002）和白蛋白水平（p值=0.003）存在显著关联。而观察到GSD与年龄（p值=0.001）、居住地（p值<0.001）和血清谷丙转氨酶（SGPT）水平（p值=0.033）存在显著关联。结论 在我们的队列中，乙型肝炎、特发性、GSD和威尔逊病是儿科患者CLD最常见的病因。此外，年龄、居住地、症状、总胆红素水平、直接胆红素水平、SGPT和白蛋白水平是重要的预测变量。
