Pediatric Liver Biopsy: A clinicopathologic study

Abstract

Extrahepatic Biliary Atresia: (Fig 1 a, b) -A total of 26 cases of EHBA were found in our study. Among these, 25 were infants. The commonest symptom was icterus followed by clay colored stools. Liver function test results were available in 17 cases. Liver enzymes were elevated in the following range -SGOT (131-405 U/L), SGPT (51-Pragati Aditya Sathe* and Dipali Eknath Mahale Department of Pathology, Seth GS Medical College& KEM Hospital, Mumbai, India ABSTRACT Introduction:The spectrum of liver diseases in children differs from that in adults. Different diagnostic modalities which are available are not capable of diagnosing the liver disease individually unless they are supplemented by a liver biopsy. Hence liver biopsy is an invaluable tool in the diagnosis of liver diseases. Aims and Objectives:The aims of this study were to study the spectrum of liver diseases in pediatric age group at our institute, to correlate the liver biopsy findings with clinical findings and laboratory investigations and to review the literature on this topic. Results:We received a total of 130 liver biopsies during the five year study. Out of these, 65 biopsies were performed in children below one year of age while the remaining 65 liver biopsies belonged to children aged more than one year. The common indications for performing liver biopsies included prolonged jaundice, clay colored stools, abdominal distension, abdominal pain, suspected inborn error of metabolism and for a suspected hepatic tumor. Extrahepatic biliary atresia was the commonest pathology found in children below one year of age whereas metabolic disease was the most common pathology found in children above one year of age. Special stains helped in refining the diagnosis further. Laboratory investigations were correlated to offer a complete diagnosis. Conclusion:Paediatric liver biopsy is of value in diagnosis of disorders where clinical and laboratory parameters overlap. At the same time, clinical and laboratory correlation is a must due to overlapping histologic features of many liver diseases.