Histopathology findings of chronic liver diseases in pediatric age group

Objectives: Early and accurate diagnosis of Chronic liver diseases (CLD) in children is very important as it is associated with major cause of mortality and morbidity. Though, nowadays most advanced and ancillary diagnostic techniques are available, Liver biopsy still plays a very important role in diagnosis of chronic liver diseases in children. The present study is aimed to study the role of liver biopsy in diagnosis of various chronic liver diseases in children and to evaluate the histopathologic findings of various liver and hepatobiliary diseases in children. Materials and Methods: This was a prospective study carried out in a large teaching hospital. Total 55 children in pediatric age group (1-12yrs) who presented with chronic liver disease were subjected to liver biopsy. Relevant investigations were done. The procedure was carried out under all aseptic condition after obtaining a written informed consent of the patient's parents. The liver biopsy procedure was done through two approaches one percutaneous and second is transjugular approach. The second approach was used in patients with deranged PT/PI, to avoid the risk of internal bleeding. The biopsy piece was collected in formalin and sent to histopathology for analysis. An expert pathologist was identified for the study of these biopsy pieces. The biopsy findings were evaluated. Results: In our study the incidence of CLD was high in 6-12 yr of age group (34.34%) with a male predominance (60%). In our study the most common presenting complaint was jaundice and abdominal distension (38.18%) followed by jaundice alone (34.54%). Liver biopsy demonstrated various histopathological abnormalities like inflammation (80%) followed by ballooning of hepatocytes (74.54%). Other findings included cholestasis /necrosis/fibrosis/glycogenation/special stains positivity/cirrhosis. The incidence of cirrhosis on liver biopsy was41.81%.We diagnosed maximum cases of Wilson's disease 12 out of which 9 patients had cirrhosis. In our study maximum (18) patients out of 55 had metabolic liver disease, followed by hepatitis (9). Conclusion: As incidence of Chronic Liver Diseases is very low in pediatric age group a very high index of suspicion is required. Every case needs through history and investigations to reach at a specific diagnosis. Liver biopsy is gold standard and plays a very important and crucial role in the diagnosis of chronic liver diseases in children.