title: Clinical profile of chronic hepatobiliary disorders in children: experience from tertiary referral centre in Western India.
abstract: OBJECTIVE
  To determine etiological spectrum as well as clinical profile of chronic hepatobiliary disorders in children.
  
  
  METHODS
  45 children with chronic hepatobiliary disorders were evaluated in the study.out of 105 children with liver diseases referred to the clinic. All underwent detailed history and clinical examination. Clinical and laboratory features as well as causes of chronic hepatobiliary disorders were studied.
  
  
  RESULTS
  The common causes were biliary atresia in 11 (25%) patients, neonatal hepatitis and Wilson's disease in 6 (13%) patients each, glycogen storage disorder (GSD) and idiopathic hepatitis in 5 patients (11%) each, Hepatitis B in 2 (5%), Hepatitis C in 1 (2%), Hepatitis B and C in 1 (2%), Caroli's disease in 2 (5%), autoimmune hepatitis in 2 (5%); sclerosing cholangitis, viral hemophagocytosis and thalassemia major in 1 (2%) patient each. Common clinical presentations were jaundice in 32 (71%), dark urine in 19 (42%), fever in 13 (29%), failure to thrive in 7 (16%), splenomegaly in 21 (47%) and hepatomegaly in 32 (71%). Also children with neonatal cholestasis presented in 1s' year of life, those with idiopathic liver disease and GSD presented within 1st 5 years of life and those with Wilson's disease. Autoimmune hepatitis, Caroli's disease presented between 5-10 years of age and viral hepatitis was seen in 2nd decade of life (p < 0.001).
  
  
  CONCLUSIONS
  Commonest cause of chronic hepatobiliary disorders in children is neonatal hepatitis. Metabolic liver disease usually presents in 1st 5 years of life whereas chronic viral hepatitis has a presentation in adolescence.
authors.affiliation: Department of Pediatric Medicine and Pediatric Surgery, Hepatobiliary Clinic, B. J. Wadia Hospital for Children, Parel, Mumbai-400012. irashah@pediatriconcall.com
authors.forename: Ira
authors.initials: I
authors.lastname: Shah
authors.forename: Susmita
authors.initials: S
authors.lastname: Bhatnagar
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001660:Biliary Tract Diseases / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008107:Liver Diseases / Q000453:epidemiology*; D008111:Liver Function Tests; D008297:Male