Role of Biopsy in Non-Neoplastic Lesions of Liver in Pediatric Patients: Diagnostic of Liver Diseases
Aim: To determine the role of liver biopsy in diagnosis of non-neoplastic liver diseases in children at a tertiary care hospital and to document frequency of these diseases.
Methods: This study was conducted at Histopathology department of Children’s Hospital and Institute of Child Health, Lahore. A total of 100 paediatric liver biopsies of patients, of ages from 1 month to 15 years were included in this study. Their demographic data was recorded. Diagnosis was made, based on morphology along with clinical grounds and laboratory investigations. Diagnoses were classified into four broad categories like metabolic, infective, congenital and idiopathic liver diseases. The data was entered and analyzed by using SPSS 20.0. P-value of <0.05 was considered as significant.
Results: Out of one hundred liver biopsies there were 56 (56%) male and 44(44%) females. Male to female ratio was 1.8:1.4. Forty two (42%) children were less than one year of age, 32(32%) children fell between 1-3 years, eight (8%) between 3-6 years, seven (7%) between 6-10 years and eleven (11%) were above 10 years of age. The most common pathology seen in this study was Glycogen Storage disease (25 %) followed by Biliary atresia (15%), PFIC (14%), Congenital hepatic fibrosis CHF (9%), Steatosis (7%), The less common entities were Idiopathic CLD (6%), Idiopathic neonatal hepatitis, Chronic Hepatitis B and Chronic Hepatitis C 4% each, Cirrhosis was seen in 3% patients out of theses two were biliary cirrhosis and one was of macro nodular type, Choledochal cyst and Autoimmune hepatitis 2% each. One case each of Wilsons disease, Granulomatous Hepatitis, Acute hepatitis, Budd Chiari syndrome and Portal vein thrombosis was also noted.
Conclusion: Metabolic liver disease and extrahepatic biliary atresia are the two most common causes of liver disease. In children, liver biopsy is of value in diagnosis of disorders where clinical and laboratory parameters overlap. At the same time, clinical and laboratory correlation is a must due to overlapping histologic features of many liver diseases.
Keywords: Paediatric, liver, biliary atresia, metabolic