Hepatic Disease in Children

Introduction

Hepatic diseases in children comprise a wide range of conditions that affect the liver. The liver is a vital organ that plays an essential role in the digestion, detoxification, and synthesis of proteins. Early detection of the condition can ensure better outcomes and minimizes the impact of the disease on the child’s life.

What Is a Liver?

The liver is one of the largest organs in the human body that performs various functions involving filtering the blood and removing toxins. The organ is spongy and wedge-shaped. And the sizes vary depending on the weight of the patient. It performs numerous functions to sustain life. Since the liver is also a gland, it makes proteins and hormones that are required by other body parts. The liver weighs roughly about three kilograms. It is situated on the right side, under the ribs. Any condition pertaining to the liver is called hepatic disease.

The liver comprises two major parts:

• The larger right lobe.

• The smaller left lobe.

These lobes comprise several blood vessels, and as the blood travels through the liver, it filters the blood and removes toxins and waste products that are eliminated from the body in the form of urine and feces.

What Are the Functions of the Liver?

The liver performs several roles to ensure the proper functioning of all body parts. Some of the functions of the liver are mentioned below:

• Clear out toxins from the blood.

• Get rid of unwanted red blood cells.

• Make bile, a fluid that aids with digesting or breaking down food products.

• Metabolizes proteins and carbohydrates.

• Releases a substance to clot blood.

• Regulates the amount of blood levels in the body.

• Stores glycogen and vitamins that can be used by the body later.

What Are Hepatic Diseases?

Hepatic diseases refer to medical conditions that cause impairment or affect the normal functioning of the liver. Some of the most common medical conditions are listed below:

• Alcohol-Related Liver Disease - It is a condition that is caused due to excessive consumption of alcohol. It may range from mild fatty liver to severe conditions like alcoholic hepatitis and cirrhosis. Hepatitis refers to inflammation of the liver. Individuals suffering from this disease should avoid alcohol consumption, which is an absolute contradiction. The management of the condition involves restricting alcohol, although it may be challenging for some individuals. In addition, following a healthy and balanced diet can help with better absorption of nutrients.

• Non-alcoholic Related Liver Disease - The condition is caused due to all other reasons other than alcohol consumption. It could be due to simple fatty liver or liver cirrhosis. This condition is often associated with obesity. Lifestyle modifications like weight loss, regular exercise, and diet can help to improve the underlying condition.

• Liver Cancer - This condition is also known as hepatocellular carcinoma. It requires prompt diagnosis and appropriate treatment. It is a type of carcinoma that develops from the liver cells called hepatocytes. It could be caused due to infection or excessive alcohol consumption. Genetic conditions play a significant role in developing liver cancer. The cancer may metastasize or spread to other organs. In the early stage of this cancer, the symptoms are not noticeable. As the condition progresses, it may cause abdominal pain, unexplained weight loss, and loss of appetite. Additionally, it may also cause jaundice, which is the yellow appearance of the skin. The treatment for this condition depends on the stage of the cancer. Generally, the options include radiation therapy, targeted therapy, and liver transplant.

• Primary Biliary Cholangitis - It is a chronic autoimmune condition of the liver that affects the bile ducts and is characterized by the gradual destruction of smaller ducts within the liver. The symptoms include fatigue, itching, dry mouth, and jaundice. In addition, some individuals may experience abdominal discomfort. The diagnosis includes a blood test to measure the liver functions for specific antibodies. Sometimes, a liver biopsy may also be done.

What Are Hepatic Diseases Specific to Children?

A few hepatic conditions specific to children are mentioned below:

• Hepatoblastoma - It is the rarest type of liver cancer that affects children. It primarily affects children who are less than five years old. The symptoms include swollen abdomen, jaundice, itchy skin, anemia, and back pain. The diagnosis includes testing the alpha-fetoprotein levels, performing a biopsy, blood test, and bone scan. The treatment involves removing the tumor tissue or using chemotherapy to shrink the tumor. The prognosis of the condition may vary from child to child.

• Neonatal Hepatitis - It is the inflammation of the liver that occurs in early infancy. It is due to viral infections like rubella or cytomegalovirus that may have affected the mother during pregnancy. The important symptom is jaundice, and the infant cannot absorb vitamins for proper growth. The diagnosis of this condition invokes liver biopsy. There are no specific treatments. Usually, vitamin supplements are prescribed, and easily digestible fats are given to infants.

• Metabolic Liver Disease - They cause the liver to lose function by causing various disorders. It blocks the pathway of the liver, which is required for breaking down nutrients.

• Wilson’s Disease - It is a rare genetic disorder found in children who have large amounts of copper in the liver and brain. It damages the nervous system and leads to neuromuscular symptoms. This disease is fatal but is highly responsive to medical treatment. The condition is diagnosed by blood and urine tests to measure the blood cells and ceruloplasmin levels. The treatment for this condition includes zinc acetate, Penicillamine, and Trientine.

• Progressive Familial Intrahepatic Cholestasis - It is a rare condition in which the children cannot drain the bile from the liver. As a result, bile acids develop in liver cells. It occurs due to specific mutated genes that produce proteins to eliminate the bile from the liver. The treatment focuses on decreasing discomfort by supplying fat-soluble vitamins.

• Biliary Atresia - It is a rare condition of the liver and bile duct that causes pale stool in children. The cause of this condition is not known. However, it is believed that it is caused due to viral infection. The treatment includes the Kasai procedure, which creates a path of bile flow from the liver into the intestine.

Conclusion

In conclusion, it is essential to treat hepatic conditions in children at the earliest stages. The commonly occurring hepatic conditions in children include hepatoblastoma, biliary atresia, neonatal hepatitis, and Wilson’s disease. Each condition may present its own set of symptoms. It is crucial to undergo treatment to prevent the disease progression, which could affect the later stages of life. With frequent follow-ups, one can ensure the prognosis of the condition and reassure normal liver functions.