Cirrhosis in children and adolescents： An overview
摘要
Several conditions, especially chronic liver diseases,can lead to cirrhosis in children and adolescents. Mostcases in clinical practice are caused by similar etiologies.In infants, cirrhosis is most often caused by biliaryatresia and genetic-metabolic diseases, while in olderchildren, it tends to result from autoimmune hepatitis,Wilson＇s disease, alpha-1-antitrypsin deficiency andprimary sclerosingcholangitis. The symptoms of cirrhosisin children and adolescents are similar to those ofadults. However, in pediatric patients, the first sign ofcirrhosis is often poor weight gain. The complications ofpediatric cirrhosis are similar to those observed in adultpatients, and include gastrointestinal bleeding causedby gastroesophageal varices, ascites and spontaneousbacterial peritonitis. In pediatric patients, specialattention should be paid to the nutritional alterationscaused by cirrhosis, since children and adolescentshave higher nutritional requirements for growth anddevelopment. Children and adolescents with chroniccholestasis are at risk for several nutritional deficiencies.Malnutrition can have severe consequences for bothpre- and post-liver transplant patients. The treatmentof cirrhosis-induced portal hypertension in children andadolescents is mostly based on methods developed foradults. The present article will review the diagnostic anddifferential diagnostic aspects of end-stage liver diseasein children, as well as the major treatment options forthis condition.