Cirrhosis in a Young Child Due to Fatty Liver; Importance of Early Screening: A Case Report and Review of the Literature

25 June 2020 : Case report USA

Challenging differential diagnosis, Rare disease

Hamza Hassan Khan^1ABCDEF*, Christine E. Klingert^12BCDEF, Sanjay Kumar^23ADEF, Hernando Lyons^23A

DOI: 10.12659/AJCR.923250

Am J Case Rep 2020; 21:e923250

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Table 1. Reported cases of NASH developing to liver cirrhosis in childhood.

Authors	Year	Patient age	Presentation		Laboratory findings				Histo-pathological findings	Miscellaneous
			BMI (kg/m2)	Clinical presentation	SGPT (IU/L)	SGOT (IU/L)	Triglycerides	Hepatitis panel
			Molleston et al. []¹⁰	2002	10	32	Patient presented with mildright upper-quadrant tenderness and fatigue	367			285	Negative for Hepatitis A, B, and C	Needle liver biopsy: cirrhosis	Prominent spleen on abdominal ultrasound
Molleston et al. []¹⁰	2002	13	37.9	Presented with weight gain and palpable hepatomegaly	88	66		Negative for Hepatitis A, B, and C	Needle liver biopsy: well-established, inactive cirrhosis	Hepatomegaly with steatosis on ultrasound Developed variceal bleeding, mild encephalopathy, and ascites at age 14
A-Kader et al. []⁷	2008	9			Elevated				Cirrhosis
A-Kader et al. []⁷	2008	9	Increase from 27.5 to 31.2	Presented with significant weight gain: BMI from 27.5 → 31.2 in 25 months	Elevated				Progression from stage 1 fibrosis to cirrhosis
Feldstein et al. []⁵	2009	11	26.9	Biopsy done due to persistently elevated liver enzymes Grade 3 esophageal varices			Hyper-triglyceridemia hyper-cholesterolemia			Liver trans-plantation at age 20 due to end-stage liver disease and hepatopulmonary syndrome – Recurrent NASH at 9 months post-transplant
Feldstein et al. []⁵	2009	18	33.6	Presented with low HDL cholesterol and hypoxemia from hepato-pulmonary syndrome					Cirrhotic stage NASH Macro-vesicular steatosis 14 days post-transplant	Required liver transplant at age 25

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