title: Prevalence of hepatic abnormalities in a cohort of Egyptian children with type 1 diabetes mellitus.
abstract: OBJECTIVE
  Children with type 1 diabetes mellitus (T1DM) are frequently investigated for hepatic abnormalities. This study was carried out to report on the prevalence of hepatic abnormalities in diabetic children and adolescents and to highlight the possible etiology and appropriate management.
  
  
  METHODS
  The study included 692 children (333 were males) with T1DM attending the Diabetes Unit at Cairo University Pediatric Hospital. Their mean age was 9.65 ± 4.18 yr. All children were subjected to clinical examination for hepatomegaly, determination of alanine aminotransferase (ALT) and antibodies to hepatitis C virus (anti-HCV), and abdominal ultrasonography. All children with clinical, laboratory or ultrasound abnormality were counseled about proper glycemic control and followed up. If abnormalities persisted, more detailed investigations were carried out. HCV RNA was done for anti-HCV positive children.
  
  
  RESULTS
  Sixty (8.7%) were found to have one or more abnormalities: clinical hepatomegaly in 13 (1.9%), elevated ALT in 27 (3.9%), anti-HCV in 25 (3.6%) and abnormal hepatic ultrasound in 31 (4.5%). Forty percent of anti-HCV positive children were HCV-RNA positive. Glycogenic hepatopathy was diagnosed in three cases by liver biopsy. Abnormalities were reversible in 37/60 after proper glycemic control.
  
  
  CONCLUSIONS
  Although diabetic children are at risk of acquisition of HCV, poor glycemic control is the key factor that predisposes to hepatomegaly, elevated ALT and abnormal ultrasound findings. A 4 to 8-wk therapeutic trial of proper glycemic control is recommended prior to more invasive diagnostic procedures.
authors.affiliation: Pediatrics Department, Cairo University, Cairo, Egypt. hanaakaraksy@yahoo.com
authors.forename: Hanaa Mostafa
authors.initials: HM
authors.lastname: El-Karaksy
authors.forename: Ghada
authors.initials: G
authors.lastname: Anwar
authors.forename: Gamal
authors.initials: G
authors.lastname: Esmat
authors.forename: Samah
authors.initials: S
authors.lastname: Mansour
authors.forename: Magda
authors.initials: M
authors.lastname: Sabry
authors.forename: Heba
authors.initials: H
authors.lastname: Helmy
authors.forename: Ahmad
authors.initials: A
authors.lastname: El-Hennawy
authors.forename: Hanan
authors.initials: H
authors.lastname: Fouad
mesh_terms: D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology*; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006526:Hepatitis C / Q000453:epidemiology; D018937:Hepatitis C Antibodies / Q000032:analysis; D006529:Hepatomegaly / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008099:Liver / Q000000981:diagnostic imaging; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008297:Male; D015995:Prevalence; D014463:Ultrasonography
chemical_list: D001786:Blood Glucose; D018937:Hepatitis C Antibodies; D000410:Alanine Transaminase