LIVER
DISEASES IN CHILDREN: PAST AND FUTURE
Dong YS, Fang F
Department of Pediatrics, Tongji Hospital, Tongji
Medical College, Huazhong University of Science and Technology, Wuhan,
China
Liver
diseases are common in children, but it should be neglected if the physical
examination and liver function test in the patients were not carefully
taken.
I. The pathophysiological basis of liver diseases
in children
1. Once
the complex, orchestrated progressing process of liver development could be
disturbed, some congenital malformations such as nodular regenerative
hyperplasia, congenital hepatic fibrosis, intrahepatic biliary hypoplasia will
develop. 2.Children take relatively more foods and water than that of
adults every day, so they have more chances to intake comtaminated
microorganisms and chemicals that could cause infectious or toxic
hepatitis. 3.There are two blood supply systems in liver and 25% of cardiac
output flows to the liver. So, the liver is easy to be involved in young
children with septicemia, some virusemia (eg. adenovirus infection) and
toxemia. 4.Most metabolic hepatopaties (eg. galactosemia, tyrosinemia) due
to inborn errors are seen in the childhood. 5.The ability of biotransformation
in young children is weaker than that in adults. Children are more
vulnerable to develop some drug-induced or toxic hepatitis.
6.Any
congenital defecit in the formation of bile acids or the drainage of bile
could cause cholestasis.
II. The variety of liver diseases in children
1.The
incidence of Hepatitis A, B and C were significantly decreased by effective
vaccination and prevention, but the infectious hepatitis caused by other
microorganisms could be seen in immunosuppressive children. 2.More and more congenital
hepato-biliary malformations and metabolic hepatopaties would be diagnosed
by means of advanced imaging, biochemical and biomolecular techniques. 3.There
might be some new liver diseases happened with the change of life-style and
environment in future.
4.More and more liver diseases in
children could be treated by chemical drugs, transplantation or gene
therapy.