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- Title
Liver disease in the older child.
- Authors
Ee, Looi C
- Abstract
Liver disease in children tends to present either as: (i) an acute hepatitis with or without jaundice; (ii) incidental finding of abnormal liver function tests; or (iii) from a complication of portal hypertension with either haematemesis and/or incidental splenomegaly. Acute hepatitis may result from acute infection, prescribed or other drugs, ischaemia or vascular causes, autoimmune hepatitis, or idiopathic liver failure. Non-alcoholic fatty liver disease is now the most likely reason for abnormal liver function tests but medications, metabolic disease, cholangiopathy and non-liver causes should be considered. Autoimmune hepatitis and alpha-1-antitrypsin deficiency are the most likely causes of insidious liver disease. An international normalised ratio uncorrected by vitamin K reflects the severity of liver synthetic dysfunction, but not propensity to bleed. Creatine kinase helps to differentiate muscle from liver disease in patients with raised transaminases. Doppler ultrasound of hepatic vasculature is useful when assessing splenomegaly to differentiate extra-hepatic portal hypertension from inherent liver disease.
- Subjects
LIVER diseases; FATTY liver; JUVENILE diseases; ALPHA 1-antitrypsin deficiency; CHRONIC active hepatitis; PORTAL hypertension diagnosis; LIVER function tests; LIVER; CIRRHOSIS of the liver; PORTAL hypertension
- Publication
Journal of Paediatrics & Child Health, 2020, Vol 56, Issue 11, p1702
- ISSN
1034-4810
- Publication type
journal article
- DOI
10.1111/jpc.14708