Liver disease in children

Dr. Isaura Cornelio Gómez, gastroenterologist-hepatologist, nutritionist, endoscopist, pediatrician. Coordinator of Pediatric Gastroenterology of the General Hospital of the Plaza de la Salud.

The liver is a large organ, located in the upper right part of the abdomen and protected for the most part by the ribs with an exclusive blood supply that comes from the heart. It is a vital organ that fulfills many functions, such as producing bile. With this substance the body absorbs the fat that we ingest as well as fat-soluble vitamins.

The liver also produces enzymes, proteins and factors that intervene in blood coagulation, regulates blood glucose and stores additional sugar, in addition to other substances, nutrients, vitamins and minerals, eliminates bacteria and toxic substances from the blood.

It prevents infections and regulates immune responses, it also processes nutrients, medicines and hormones.
There are many types of liver diseases in children. Many of them are congenital and others acquired after birth both in childhood and adolescence.

What are the symptoms of a child with liver disease? One of the most important symptoms that can be observed by the parents is jaundice (yellowing of the eyes and skin), pale or white stools, dark urine, enlarged abdomen due to liver growth and the spleen, abdominal pain, fever, chronic fatigue, pruritus or itching in the body, little weight gain, swelling in the feet or easy bruising of the skin, among others. These symptoms are always accompanied by alteration of liver tests, confirming the diagnosis.

What are the liver diseases that can affect children? The term hepatitis is used to describe inflammation of the liver and may be caused by one or several factors. Many viruses can affect the liver in children being one of the most frequent hepatitis A, which is acquired by the consumption of contaminated food.

Other diseases can be acquired before the baby is born and have a more complex course. Among these, atresia of the biliary tract is the most frequent disease that entails greater morbidity and mortality; therefore, making a diagnosis on time is crucial for good prognosis.

Some viral infections in the mother during the last stage of pregnancy can be transmitted to the child and cause severe liver disease at the time of birth. Other causes may be diseases caused by a metabolic defect, which can manifest from birth or at any time of childhood or adolescence.

Also the diseases of the liver of autoimmune origin are frequent cause. One of them is autoimmune hepatitis, which can occur at an early age.

Other diseases can be genetic (family inheritance) or due to hepatic immaturity (preterm birth), secondary to serious bacterial infections, hypoxia (lack of oxygenation to the brain) during birth, neonatal congenital viral infections, diseases caused by drugs, consumption of toxic substances, medications, postnatal viral infections or obesity, among many others.

To perform the diagnosis of these diseases, it is necessary to analyze blood tests, perform imaging studies and a liver biopsy.

Published in: Hoy Digital newspaper.