Cirrhosis in children and adolescents: An overview

作     者：Raquel Borges Pinto Ana Claudia Reis Schneider Themis Reverbel da Silveira 

作者机构：Pediatric Gastroenterology Unit Hospital da Crianca Conceicao Porto Alegre 91340 480 Rio Grande do Sul Brazil Post-Graduate Program in Gastroenterology and HepatologyUniversidade Federal do Rio Grande do Sul Porto Alegre RS 90040-060 Brazil. 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2015年第7卷第3期

页      面：392-405页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

基　　金：FIPE-HCPA(Research Incentive Fund-Hospital de Clinicas de Porto Alegre) 

主　　题：Cirrhosis Liver diseases Nutrition Pediatric patients Portal hypertension 

摘      要：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.