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2015 ; 7
(3
): 392-405
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Cirrhosis in children and adolescents: An overview
#MMPMID25848466
Pinto RB
; Schneider AC
; da Silveira TR
World J Hepatol
2015[Mar]; 7
(3
): 392-405
PMID25848466
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Several conditions, especially chronic liver diseases, can lead to cirrhosis in
children and adolescents. Most cases in clinical practice are caused by similar
etiologies. In infants, cirrhosis is most often caused by biliary atresia and
genetic-metabolic diseases, while in older children, it tends to result from
autoimmune hepatitis, Wilson's disease, alpha-1-antitrypsin deficiency and
primary sclerosing cholangitis. The symptoms of cirrhosis in children and
adolescents are similar to those of adults. However, in pediatric patients, the
first sign of cirrhosis is often poor weight gain. The complications of pediatric
cirrhosis are similar to those observed in adult patients, and include
gastrointestinal bleeding caused by gastroesophageal varices, ascites and
spontaneous bacterial peritonitis. In pediatric patients, special attention
should be paid to the nutritional alterations caused by cirrhosis, since children
and adolescents have higher nutritional requirements for growth and development.
Children and adolescents with chronic cholestasis are at risk for several
nutritional deficiencies. Malnutrition can have severe consequences for both pre-
and post-liver transplant patients. The treatment of cirrhosis-induced portal
hypertension in children and adolescents is mostly based on methods developed for
adults. The present article will review the diagnostic and differential
diagnostic aspects of end-stage liver disease in children, as well as the major
treatment options for this condition.
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