Screening for metabolic liver diseases crucial to increase SVR to patients with CHC

Liver diseases and its complications is common health problem worldwide. The emergence of metabolic disorders as a cause after exclusion of viral hepatitis nowadays is important. This is retrospective study on 200 patient's age range from 6 months to 18 years old [50 females and 150 males]. The patients divided into 2 groups according to age < 5 years and >5 years and all investigations done was collected and statistically processed. Abdominal enlargement was observed in 166/200 of all patients, 48/166 [67.6%] in patients <5 years old and 118/166 [91.5%] in patients >5years old with statistical significant, jaundice was present in 34/200 of patients, 23/34 [32.4%] in patients <5 years old and 11/34 [8.5%] in patients >5 years old, with statistical significant difference, CBC was normal in 58/200 of all age groups. 10/58 [14.1%] in patients <5 years old, 48/58 [73.2%] in patients <5 years old, with statistical significant difference and abnormal CBC in 142/200 [61/142, 62.8%] in age group > 5 years old, 81/142 [85.9%] in age group <5 years. Metabolic disorders was normal in 124/200 of all age groups, 23/124 [32.4%] in patients <5 years old. Metabolic disorders was abnormal in 76/200 of all, 48/76 [67.6%] in patients >5 years old and 28/76 [21.7%] in patients < 5 years old, with statistical significant difference and for both age groups. The sensitivity of modalities used in the diagnosis of liver disease was as follow for US, study of metabolic profile, abnormal liver functions and abnormal CBC, 83.1%, 65.2%, 61.6% and 66.1% consequently

Study of the immune response of hepatitis B vaccination in Egyptian pre-school children

Abstract: Although immunization of infants against hepatitis B virus [HBV] is the most effective way to prevent infection, duration of the afforded protection is controversial. Titers of ani-HBV antibodies tend to decline with age. The Aim of this study is to evaluate the immune response to hepatitis B vaccination in a sample of vaccinated Egyptian pre-school children and the impact of serum ferritin on this response

Subjects and Methods: Serum samples were collected from 91 apparently normal children 5-6 years old, who were fully vaccinated in infancy according to Egyptian immunization schedule, during the period from January to June 2005. HBs antibody titer was assayed by ELIZA, colorimetric determination of serum albumin and serum ferritin estimation by enzyme immunoassay were performed. Body mass index [BMI] was calculated in all children

Results: A total of 49 [53.8%] tested positive response for HBs antibody including [43 weak responders [10-100m IU/L] and 6 high responders [>100mIU/L]] and 42 [46.2%] showed inadequate response [< 1mIU/L]. The mean value of serum ferritin [86.9 ug/L] in responders was significantly higher [P = 0.001] when compared to inadequate responders [62.8ug/L]. No statistically significant difference regarding sex, locality [rural or urban], serum albumin and BMI were detected in between

Conclusion: High ferritin level [within normal range] may contribute to good immune response to hepatitis B vaccine. Booster dose of HB vaccine should be highly considered to enhance immune protection of the vaccine

Spectrum of chronic liver diseases in Egyptian children in Benha

We studied Retrospectively 70 patients with chronic liver disease in Benha University Hospital from 2000 to 2004. Our aim was to define the spectrum of chronic liver diseases presented to our pediatric hepatology clinic. The study included 50 males and 20 females with age ranging from 21 days to 13 years. All patients underwent liver biopsy, sonographic and biochemical analysis. Our results revealed that sixteen patients [22.85%] had chronic hepatitis, 12 [17.14%] had cholestasis, 12 [17.14%] had metabolic liver diseases, 7 [10%] had active micro nodular cirrhosis, 5 [7.14%] had hepatoportal fibrosis, one case [1.42%] had congenital hepatic fibrosis and 3 [4.28%] had fatty infiltration. Three patients [4.28%] had vascular hepatic disorders, 1 [1.42%] with parasitic hepatic infestation, 1 [1.42%] had osteopetrosis and 9 [12.85%] had non specific changes. We have tried to use an independent predictor of liver fibrosis [AST/ALT ratio] and our results show that its sensitivity and specificity were [68.1%] and [60.4%] respectively. We concluded that liver biopsy should be performed as early as feasible in the course of liver disease and should be repeated. It will not only facilitate diagnosis and treatment but also help to increase our understanding of the various disease processes

Lipid profiles and lipoprotein [Lp a] levels of marasmic children: the influence of short rehabilitation

The biochemical changes of lipid me tabolism in marasmic children before and after nutritional treatment were evaluated in thirty patients with age ranging from 6 to 24 months. All subjects were submitted to anthropometric measurements, liver and kidney function tests, lipid profiles, lipoproteins and lipoprotein [a] [Lp[a]] levels. All studied parameters were repeated one month after nutritional therapy. The results showed significant increase in weight, midarm and chest circumferences of cases after nutritional therapy. No significant differences were detected in serum total protein, albumin, AST, ALT, urea and creatinine. The laboratory results of lipid profiles after treatment showed significant decrease of mean serum levels of total lipids and triglycerides, meanwhile mean levels of total cholesterol [TC], and lipoproteins [HDL-c, LDL-c and Lp [a]] were significantly elevated. The risk ratios TC/HDL-c and LDL/HDL-c were not changed significantly after treatment. Our results indicated that improvement of the studied anthropometric measurements in marasmic children after short dietatic therapy is attributed mainly to changes in lipid profiles and that diet has some influence on Lp [a] levels in those children