Spectrum of Liver Diseases among Children in Kashmir Valley

A hospital based descriptive study was conducted to assess the magnitude and spectrum of liver disorders among children attending department of gastroenterology at SKIMS.  The study included children <18 yrs with liver disorders.  A total of 186 children with confirmed diagnosis of liver disease were included in the study.  Mean age of patients was 9.3 ± 4.8 yrs with a range of 1-18 yrs.  The diagnosis of all liver diseases was based on established clinical and diagnostic criteria.  These children were divided into subgroups of Acute Liver Disease (ALD), Chronic liver disease (CLD), Neonatal Cholestasis Syndrome and miscellaneous disorders.  Severity of chronic liver disease was defined using Child grading. Spectrum of liver diseases in children included chronic liver disease (50%), acute liver disease (31%), hydatid liver (7.5%), congenital hyperbilirubinemia (3%) and miscellaneous. Jaundice (75%), ascitis (64%), encephalopathy (29%) were presenting symptoms in chronic liver disease patients indicating decompensation at presentation. Features of portal hypertension were seen in 65%.  Etiology was found to be HBV in 18%, Wilsons disease in 16%, HCV  in 6.4%, autoimmune in 5.3% and alpha-1 antitrypsin deficiency in 1.1%  and no etiology could be found in 52% (cryptogenic).  In acute liver diseases HAV was cause in 43%, HBV in 27% and HEV in 7% cases. Keywords: Children, Cirrhosis, Cryptogenic, HBV, HCV, Liver Diseases