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      What is the most common cause of cirrhosis in childhood - Dr. Bipin Vibhute
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      What is the most common cause of cirrhosis in childhood

      by | Jul 24, 2020 | Q & A's Liver Cirrhosis

      Out of the various organs in a human body, the liver performs some of the most important functions. This includes processing the good nutrients and passing it to the different parts of the body while removing the toxins. However, due to many reasons and medical issues, the liver stops working properly and that leads to severe issues.

      This condition is visible in both adults and children and the symptoms and causes for them are similar to some extent. Yet, when the matter of liver cirrhosis in children comes up, there are some particular factors that are responsible. Thus, knowing what are the causes of liver cirrhosis in child would help you treat and prevent it in a timely manner.

       

      What is liver cirrhosis?

      To elaborate, liver cirrhosis is a condition in the liver that occurs when certain diseases harm the smooth functioning of it. To fix the issues, the liver tries to replace the affected area with healthier tissues. However, with time, a layer of scar tissues takes the place of the healthier tissues, and that causes more drastic liver diseases.

      This is hard to diagnose in many situations, as the liver cirrhosis symptoms appear later. In extreme conditions, liver failure occurs and liver transplantation is the only viable procedure left. In the case of the children, most of the causes are due to pre-existing conditions that were inherited.

      However, it is important to note that causes related to alcohol consumption are not applicable to these younger patients. Even if their parents are regular drinkers or have non-alcoholic fatty liver disease, this does not transfer to their child.

      There are some other factors and diseases that affect the livers of children, three of which are the most common. They are mentioned hereafter.

      1. Biliary Atresia

      Biliary atresia is a very common cause of liver cirrhosis, especially in children. To put it simply, this occurs due to some scarring in the bile ducts of the patient. The main function of the bile duct is to transfer bile to and from the organ of the liver and the intestines. However, when a blockage forms in these ducts, the bile cannot leave the liver region.

      Thereafter, the excess amounts of bile erode the liver and this causes it to stop working. The complications of liver cirrhosis from biliary atresia are severe and generally result in transplantation or another condition called chronic cholestasis.
      Moreover, biliary atresia causes cirrhosis mainly in infants and newborns, specifically in the first few weeks after birth. Indeed, this inherited condition is life-threatening if not treated, and surgery is the main manner of treatment.

      2. Autoimmune hepatitis

      Another major cause of liver cirrhosis in children is autoimmune hepatitis. Generally, this type of hepatitis is visible in older children and mostly in adolescents. Not to mention, it is the most harmful form in some ways, as the main attacker in this situation is the immune system itself.

      To specify, autoimmune hepatitis occurs when the immune system of the child cannot differentiate between good cells and bad cells. Thus, the immune cells go against the liver cells and that leads to internal issues and liver failure. In this situation, the symptoms appear very late and the liver functions suffer drastically.

      Owing to this, the doctors cannot catch the hepatic cirrhosis of the liver until the later stages and aggressive treatment is necessary. Catching it fast is the only method available for proper treatment; however, in most cases, it remains almost incognito. Herbal medication can work to make the body feel better, though it cannot completely heal the liver.

      3. Wilson’s disease

      Wilson’s disease is another common cause of liver cirrhosis in children, and it has serious ramifications if not treated in time. To put it simply, this disease occurs mainly in older children, and it is hereditary. In fact, most cases of Wilson’s disease in children were found after their family members were diagnosed first.

      In this scenario, the chromosome 13 mutates and causes issues like liver failure, acute hepatitis, portal hypertension, cirrhosis, and gallstones. This particular gene works on the protein that allows healthy metabolism, and biliary excretion of copper. However, a liver cirrhosis test in this condition shows that the copper deposits itself in the cornea, brain, and liver after the mutation.

      Usually, doctors find the symptoms of this disease in adolescents during their checkup for other chronic liver diseases. Wilson’s disease, on the other hand, takes a long time to manifest (around three years) and that is why it is not detected early.

       

      Some Other Causes

      While the above-mentioned forms are the most common causes of liver cirrhosis in children, they are not the only ones. Certainly, there are some other major factors that cause liver cirrhosis early signs and symptoms; however, many are rare. Not to mention, some of them are hard to diagnose as well in the early stages, but they have a significant impact on the liver functions of a child.

       

      Autoimmune diseases

      Certainly, autoimmune diseases are rare when it comes to liver cirrhosis in children, but they are worth mentioning. Aside from autoimmune hepatitis, the other two such diseases are primary biliary cirrhosis and sclerosing cholangitis. The former is not too common among children, though some reports show its availability.

      On the other hand, the latter occurs due to certain changes in some of the antigens, though the exact cause is not diagnosed. One of the known things about sclerosing cholangitis is that it comes with inflammatory bowel disease.

       

      Chronic viral hepatitis

      Another common reason for liver cirrhosis pain in children is viral hepatitis, or specifically, hepatitis C and B. It is really hard to assess the symptoms of it early though, and they usually appear in adulthood. In many cases, having this condition in childhood leads to other issues like hepatocellular carcinoma.

       

      Fatty liver disease

      Fatty liver disease is another common cause of cirrhosis, although the effect of it is felt more in adults. Not to mention, the main reason for this disease in elders is alcohol, but that is not the case for children. Instead, obesity does result in more concentration of fat inside their livers and that results in this disease. After a while, this deposit causes scarring in the tissues, and liver cirrhosis occurs.

       

      Alpha-1 antitrypsin deficiency

      The liver releases many healthy cells and other particles into the bloodstream of human beings. However, in some cases, some mutated genes stop the release of the glycoprotein named Alpha-1 antitrypsin in the blood. Thus, this deficiency causes issues in the liver and that also results in inflammation. Indeed, this is one of the possible liver cirrhosis causes in children.

       

      Heart defects

      In some children, certain defects are visible in the heart at birth, and that can affect the liver condition too. Ultimately, that results in liver cirrhosis.

       

      Cystic fibrosis

      One of the common causes of liver cirrhosis in adults and children is cystic fibrosis. To specify, this condition is a genetic disease that some children have. Accordingly, a layer of mucus forms in the organs of the body, including the liver. Owing to this, scarring occurs inside this organ, and that ultimately results in liver cirrhosis.

      All in all, there are many factors that can lead to liver cirrhosis in the childhood of a person. Most of them are hard to catch early, but proper medication is necessary before conditions worsen. While ayurvedic medicine does help, some conditions if caught late can only get solved with transplantation.

      Answered By

      Dr. Bipin Vibhute

      Liver and Multi-Organ Transplant Surgeon,

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