Erschienen in:
02.01.2020 | Original Article
Causes of secondary non-alcoholic fatty liver disease in non-obese children below 10 years
verfasst von:
Engy A. Mogahed, Al-Hussien A. Sayed, Sara E. Khalifa, Ahmed El-Hennawy, Mona S. El-Raziky
Erschienen in:
European Journal of Pediatrics
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Ausgabe 5/2020
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Abstract
This study aimed to detect etiologies and histopathological features of non-alcoholic fatty liver disease (NAFLD) in Egyptian children < 10 years from hepatologist perspectives. Infants and children below 10 years of age with biopsy-proven fatty liver over a 6-year period were included. NAFLD activity score was used to detect the presence of non-alcoholic steatohepatitis (NASH). The study included 66 cases whose age ranged between 5 months and 10 years. Transaminases were elevated in 60% patients. Glycogen storage disease (GSD) was the most common diagnosis (33.3%) followed by hepatitis C virus (HCV) (10.6%) and Chanarin-Dorfman syndrome (CDS) (9.1%). The cause of steatosis could not be identified in 28.8% of cases. There was a higher prevalence of secondary causes of NAFLD in patients < 10 years. Liver histopathological examination revealed preserved lobular architecture in 75.7% with minimal-to-mild fibrosis in 79%. Steatosis was macrovesicular in all specimens (severe steatosis in 39.4%). Four patients had NASH. Higher degree of steatosis was associated with more severe fibrosis (P = 0.01).
Conclusion: GSD was the commonest cause of secondary NAFLD in Egyptian children < 10 years followed by HCV and CDS with higher degrees of steatosis in younger patients. The degree of fibrosis was significantly related to the degree of steatosis.
What is Known: • Primary non-alcoholic fatty liver disease (NAFLD) is rare in children aged less than 10 years. • Secondary causes of NAFLD should be considered in patients who do not have traditional risk factors. |
What is New: • Glycogen storage disease, hepatitis C virus, and Chanarin-Dorfman syndrome are the commonest causes of secondary NAFLD in Egyptian children (< 10 years) with higher degrees of steatosis in younger patients. • The degree of liver fibrosis is significantly related to the degree of steatosis. |