No matter how tragic it may be, today a lot of kids are prone to various ailments that can lead to serious complications. Therefore, for any manifestations of any disease, you should immediately contact a specialized specialist. In children, cirrhosis is much less common than in adults. Usually it is a consequence of viral hepatitis in an anicteric form. In newborns, cirrhosis of the liver may be due to transmission of the virus through the placenta. Among patients with viral hepatitis B, the frequency of the disease can reach 0.5%. Let's try to figure out what causes cirrhosis in a child, how this pathology is treated and how it can be avoided.
Causes
So, let's dwell on this in more detail. Cirrhosis refers to any inflammatory chronic process in the liver, accompanied by angular proliferation of the parenchyma. Connective tissue grows with this disease. As a result, the lobular-vascular architectonics of the liver is disorganized. Signs of inflammatory and hepatic cell disorders appear.
Cirrhosis of the liver in a child is the result of congenital malformations of the biliary tract. This can be a cyst of the common bile duct, atresia of the bile ducts, a cyst of the common bile duct, partial stenosis of the bile ducts. Hepatocerebral dystrophy or fermentopathy can still lead to cirrhosis. Toxic manifestations of the disease in infants, unlike adults, are extremely rare.
In childhood, there can be quite a lot of reasons for the development of such a terrible disease as cirrhosis. Usually the cause is damage to the hepatobiliary system. However, the problem may lie in other factors.
Causes of the development of the disease in newborns
Where can cirrhosis of a child in 3-4 months come from? Such a disease in a baby is able to develop as a result of transplanetary transmission of infection from the mother's body. In addition, the cause may be congenital overgrowth of the bile ducts.
Liver cirrhosis in a small child develops if the mother suffered such diseases during pregnancy:
- rubella;
- herpes;
- viral hepatitis;
- syphilis;
- toxoplasmosis.
Causes of the development of the disease in older children
In a child of preschool and school age, cirrhosis of the liver can appear as a result of:
- Postponed viral hepatitis.
- The effects of toxins (exposure to drugs, poisoning by toxic substances).
- Congenital genetic pathology (bile duct dysplasia, Alagil syndrome).
- Autoimmune hepatitis (with this pathology, antibodies in the body are produced to own hepatocytes).
- Heart failure. May develop with heart disease in a newborn.
- Alcohol abuse in adolescence.
Heredity
What else can provoke cirrhosis in children? The reasons may be related to poor heredity. As a rule, all of them are caused by metabolic disorders.
The problem may be in the following ailments:
- Hemosiderosis (iron due to the lack of necessary enzymes is not absorbed in the intestine, but is introduced into the liver tissue by the bloodstream).
- Konovalov-Wilson's disease (copper accumulates in the liver cells due to metabolic disorders).
- Alpha-1-antitrypsin deficiency (as a result, proteins form in the hepatocytes that lead to liver damage and the development of cirrhosis).
- Cystic fibrosis (due to impaired sodium metabolism, bile viscosity increases, resulting in blockage of the bile ducts and cirrhosis).
Symptoms
This issue should be emphasized. The main symptoms of liver cirrhosis are compaction and enlargement of the liver, spleen, development of the subcutaneous venous network in the back, abdomen and chest, yellowing of the skin, itching, palmar erythema, ascites, telangiectasia. All these signs are observed with cirrhosis of the liver in adults. Usually a child suffering from this disease lags behind in sexual and physical development. However, due to a violation of hormonal homeostasis in girls, premature puberty is often observed.
Cirrhosis at the stage of compensation may well occur without visible symptoms. It is detected by accident, for example during a routine inspection. It is expressed in increased fatigue, delayed increase in body weight, impaired general well-being. Characteristic symptoms are also pain in the right hypochondrium. Some still have moderate impairment of fat and protein metabolism.
For the stage of subcompensation, symptoms may increase. Over time, signs of liver failure and portal hypertension appear. During decompensation, ascites occurs. Complications are frequent nasal and gastroesophageal bleeding.
In newborns, such manifestations of cirrhosis of the liver as a discoloration of the skin and mucous membranes are usually found. Another clear sign is the light color of feces. Bruising can occur on the body and face. Blood can ooze from the rest of the umbilical cord. A venous network is clearly visible on the abdomen. In the urine, residues of pigment bile can still be observed.
Diagnostics
What is she like? How to detect cirrhosis of the liver? Symptoms in children can be quite lubricated. Therefore, a comprehensive diagnosis is needed. It is mainly carried out using the same methods as in adults. In the early stages of the disease, tomography, angiography, dynamic hepatobiliscintigraphy, mesentericography can be used. A puncture liver biopsy is rarely done.
As for laboratory tests, as a rule, cirrhosis of the liver in a child can be determined by a general blood test. The results will be characterized by a sharp increase in the number of reticulocytes, a decrease in the level of leukocytes and erythrocytes, and an increased erythrocyte sedimentation rate. Hepatic tests with the disease in question are usually characterized by high rates of direct and indirect bilirubin. Blood biochemistry is likely to show a decrease in electrolyte composition. During a comprehensive diagnosis, a qualified doctor prescribes a urinalysis. With cirrhosis of the liver, he will show a large number of white blood cells, protein, red blood cells and squamous cells.
Treatment
What should be done when a disease such as liver cirrhosis is detected in children? Clinical recommendations in this case will be almost the same as with adult therapy. If the disease arose as a result of a virus, antiviral therapy may be prescribed. Such treatment is usually carried out in courses. It helps to reduce the activity of the virus, as well as increase the immunity of the child.
If the cause of cirrhosis is an autoimmune disease, then the patient is usually prescribed long-term treatment with hormonal drugs. Scientifically, they are called glucocorticosteroids. The doctor still prescribes choleretic drugs, but only in the absence of contraindications.
What other methods can be used to overcome cirrhosis in children? Treatment usually includes detoxification therapy. Since the liver alone cannot neutralize toxins that appear as a result of the breakdown of drugs and proteins, the patient needs to be injected with a solution of glucose, hepatoprotectors, albumin.
Adsorbents such as Smecta, Enetrosgel, Laktofiltrum can be used to remove toxins from the body. These drugs are based on lactulose. In some cases, in the treatment of cirrhosis, a plasmapheresis procedure is prescribed. In addition, a professional doctor recommends the use of diuretics in ascites. If bleeding occurs, transfusion of a donor mass of red blood cells may be required.
Thus, the choice of treatment method is largely determined by the cause of the cirrhosis of the liver in the child.
Surgical methods
Such a terrible diagnosis, as biliary cirrhosis of the liver, in children without fail requires an organ transplant. In this case, the donor can be a close relative of the baby - the mother or father. It must be not only genetically compatible, but also healthy. The presence of viral infections leading to the development of cirrhosis, and alcoholism are clear contraindications.
Possible complications
If you do not start treating cirrhosis in a child in time, the consequences can be pretty disastrous.
The most common complications include:
- ascites;
- liver failure;
- portal hypertension;
- hepatic coma;
- fatal outcome.
Forecasts
What is worth counting on? When it comes to how to treat cirrhosis in a child, predictions may not be the best. The disease leads to complete depletion of the child's body. Predictions are more dependent on the causes of the development of the disease. However, only a transplantation of a donor liver will help to achieve full recovery.
Dieting
An integral part of the treatment of such a serious disease as cirrhosis of the liver in a child is proper nutrition. Compliance with a certain diet complements the medical treatment and helps slow down the development of the disease. The basis of the diet for cirrhosis is table number 5 according to Pevzner's classification. Before you start following a diet, be sure to consult your doctor. There may be some features related to the stage and severity of liver disease.
If cirrhosis is at the stage of compensation, and the ammonia content in the blood is normal, the diet may contain complete proteins. They can enter the child's body with products such as milk, cottage cheese, beef, low-fat fish, buckwheat, millet, oatmeal. If we are talking about a disease at the stage of compensation, then the amount of protein consumed per day must be reduced to 20-30 grams. If there is no improvement in the condition of the child, proteins should be completely eliminated.
Fat in the diet should be limited. It is better to eat only ingredients of plant origin. In some cases, they are completely excluded from the diet.
The basis of the diet for cirrhosis should be carbohydrates. They can be eaten in the form of puddings, stale white bread, jam, honey, jelly, butter cookies, jelly, fruit, stewed fruit. Sweets and sugar can not be eaten more than 100 grams per day. All dishes are eaten exclusively boiled or steamed. Fried and smoked food must be completely removed.
With liver cirrhosis, you can’t eat foods such as fatty meat, sausages, fatty fish, canned food, liver, kidneys, broths, okroshka, green cabbage soup, margarine, rich flour products, fresh bread, salted and spicy cheeses, mushrooms, fatty cottage cheese, legumes, garlic, onions, sorrel, spinach, radish, pickled vegetables, spices, carbonated drinks.
Diet for cirrhosis should consist of 5-6 meals. The amount of salt and fluids consumed is best agreed with your doctor.
Conclusion
In this review, we examined what constitutes cirrhosis of the liver in children, the clinical recommendations that doctors give for this pathology, treatment methods and prognoses. In any case, this disease is very serious. It is imperative to take timely measures to combat the disease. The course of drug treatment and following an appropriate diet will help prevent the development of complications.
Try to accustom your baby to a healthy lifestyle from an early age, and then various ailments can be avoided.