title: Early childhood cirrhoses (ECC) in Germany between 1982 and 1994 with special consideration of copper etiology.
abstract: In a multicentric retrospective clinical study with 16 pediatric centres we identified 103 cases of histologically confirmed early childhood cirrhosis (ECC) in Germany for the years 1984-1994. The most prominent diagnoses were congenital bile duct anomalies (47.5%), inborn metabolic disorders (17.5%) and unclear etiologies (17.5%). Chronic and excessive intake of copper might be discussed as an etiological factor in 8 other cases. 5 of these were proven to have coincided with very high hepatic copper contents and copper plumbing/acid well water. Their connection with copper exposure must be considered as probable, whereas 3 others were only suspected copper cases, mainly due to reliable exclusion of other etiologies. High corrosivity (base capacity) values and copper levels in the water for infants formula of 9-26.4 mg/L were determined in those probable cases for which exposure conditions could be exactly reproduced. Additional reports on copper associated ECC, either Indian Childhood Cirrhosis (ICC) from outside India or so-called Idiopathic Copper Toxicosis ( ICT ), originate from Austria, Australia, Germany, Ireland, USA.
authors.affiliation: Institut für Wasser-, Boden- und Lufthygiene des Umweltbundesamtes, B.P. 330022, D-14191 Berlin, Germany. hermann.dieter@uba.de
authors.forename: H H
authors.initials: HH
authors.lastname: Dieter
authors.forename: W
authors.initials: W
authors.lastname: Schimmelpfennig
authors.forename: E
authors.initials: E
authors.lastname: Meyer
authors.forename: M
authors.initials: M
authors.lastname: Tabert
mesh_terms: D002675:Child, Preschool; D003300:Copper / Q000633:toxicity*; D003343:Corrosion; D004326:Drinking; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008103:Liver Cirrhosis / Q000139:chemically induced* / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D012189:Retrospective Studies; D012498:Sanitary Engineering; D014874:Water Pollutants, Chemical / Q000633:toxicity; D014881:Water Supply
chemical_list: D014874:Water Pollutants, Chemical; D003300:Copper