ABSTRACT
The objective to evaluate the factor of apoptotic signal [FAS] and B-cell leukemia lymphoma [BCL-2] oncoprotein as markers of apoptosis in children with chronic hepatitis C . The study included 100 children with chronic hepatitis C, divided into three groups. Group I [control, n =20] HCVantibodies and RNA-PCR negative, Group II; [n=60] HCVantibodies positive and HCV- RNA positive without liver cirrhosis and Group III; [n=20] HCVantibodies positive and HCV-RNA positive with liver cirrhosis
Blood samples were subjected to: Complete blood count, liver function tests, alpha fetoprotein assay by ELISA method, FAS [CD95] antigen, and intracellular BCL-2 oncoprotein on lymphocytes by flow cytometry
The Results showed that FAS was significantly higher in group II and group III as compared to group I [P=0.0 for both]. FAS was significantly higher in group III than group II [P=0.021]. Positive correlation between FAS and ALT, AST, and AFP was found [r =0.39, 0.47 and 0.39, respectively, P = 0.0 for all]. Combining groups II and III, negative correlations between FAS and platelets and albumin [r= -0.52 and -0.46, respectively, P = 0.0 for both]. BCL-2 was significantly higher in group II and group III as compared to group I [P=0.001 and 0.0, respectively]. BCL-2 was higher in group III than group II [P= 0.0]. BCL-2 was positively correlated to ALT, AST, and AFP [r= 0.29, 0.39 and 0.41, respectively, P= 0.0 for all]. BCL-2 was negatively correlated to platelets and albumin in the combined diseased group [r= -0.53 and -0.41 respectively and P= 0.0 for both]. A positive correlation was found between FAS and BCL-2 in the diseased group [r=0.321 and p=0.007]
In Conclusion: FAS and BCL-2 as an apoptotic markers play an important role in the pathogenesis and further outcome of chronic liver diseases
ABSTRACT
Hepatic Veno-occlusive disease [HVOD] was described as a non portal cirrhosis occurring frequently in children and occasionally in adults. The syndrome was described under different names in different areas of the world. The pathogenesis is obscure but most likely relates to venous endothelial injury. HVOD has been recognized as being due to the toxic effects of pyrrolizidine alkaloids or recently anti-neop1astic drugs or it may be familial. The clinical diagnosis may be quite accurate with acute onset ascites,hepatomega1y or right upper quadrant pain with or without jaundice. The different reports from E0 g,ypt describing the syndrome the clinical picture, the pathology and the etiology revealed that HVOD IS not uncommon among Egyptian infants and young children. They also have shown clearly that hepatic vein occlusion should be considered in the diagnosis of Egyptian children presenting with hepatosplenomegaly
ABSTRACT
Background/Aim: Endoscopic variceal sclerotherapy [EVS] has emerged as an effective treatment for bleeding esophageal varices in adults and children. We tried to study many factors affecting outcome of endoscopic sclerotherapy which is poorly defined in children with portal hypertension due to liver disease
Methods: Retrospective random study of children group [number 49] was presented by oesophageal variceal bleeding mostly hematemesis underwent endoscopic injection treatments with 1% ethanolamine maleate at period from 2003 to 2005. All children continued to receive the therapy by repeated intra and extravariceal endoscopic sclerotherapy not exceeding 8 cm for each sitting at intervals of weeks to months aiming varices to disappear or become grade I and II. They all received regular propranolol medication since they had been diagnosed [2 mg/ Kg in most of them], Children were sedated by propofol during sclerotherapy. We studied etiology, presentation, duration of the disease, number of sclerotherapy sittings and propranolot dosage in relation to good outcome [grade I, II] by suitable statistical analysis
Results: 49 child [aged 2 to 17 years], 30 male and 19 females, had totally 141 injections, and were followed up regularly by upper GI. endoscopy. The most common etiologies were CHF [no=11], AIH [no=9], Wilson's disease [no= 8] followed by BCS [no=7] and other miscellaneous [no=14]. The good outcome [eradication, grade I or II] was in 19 out of 49 [38.78 %], 10 out 19 [52.63%] was in child B classification category. 17 children received 2-10 sitting to reach grade I and II. and the duration of injection sittings of 13/19 [68.42%] was just one year. 10/19 [52.63%] patients were above 10 years old age at end of sclerotherapy and 11/19 [57.89%] of patients diagnosed since 5 years. Good outcome was related with highly significance to duration since first sitting and was correlated significantly to etiology, child classification, years of diagnosis, and number of sittings
Conclusions: Endoscopic sclerotherapy in children is a safe and effective treatment for oesophageal varices due to liver disease. Good outcome was there in some etiologies, and was correlated significantly to child's B classification, early diagnosis before treatment, period since first sitting and number of sittings. These factors had to be studied on large cohort and extended research to clarify this correlations