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Chronic Liver Disease

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Chronic Liver Disease

Chronic Liver Disease (CLD) in children refers to progressive liver damage lasting more than six months, leading to fibrosis, cirrhosis, and liver dysfunction. It can result from various congenital, genetic, metabolic, and infectious causes.

Etiology (Causes)

  • Congenital & Biliary Disorders – Biliary atresia, Alagille syndrome

  • Metabolic & Genetic Disorders – Wilson's disease, Alpha-1 antitrypsin deficiency, Glycogen storage diseases

  • Autoimmune Liver Diseases – Autoimmune Hepatitis (AIH), Primary Sclerosing Cholangitis (PSC)

  • Infectious Causes – Chronic Hepatitis B & C

  • Fatty Liver Disease (NAFLD/NASH) – Due to obesity & metabolic syndrome

Complications

  • Portal Hypertension – Leads to variceal bleeding, ascites, splenomegaly

  • Liver Cirrhosis – Scarring of the liver affecting its function

  • Growth & Nutritional Deficiencies – Malabsorption of vitamins A, D, E, K, and protein-energy malnutrition

  • Hepatic Encephalopathy – Toxin buildup affecting brain function

  • Liver Failure – End-stage liver disease requiring transplantation

Management

  • Nutritional Support – High-calorie, protein-rich diet; fat-soluble vitamin supplements

  • Medical Therapy – Depends on the cause

  • Steroids & Immunosuppressants (for autoimmune diseases)

  • Copper chelation therapy (for Wilson's disease)

  • Antiviral therapy (for Hepatitis B/C)

  • Portal Hypertension Management – Beta-blockers, variceal banding

  • Liver Transplantation – Indicated in end-stage liver disease or severe metabolic liver disorders