Oxidant sress and chronic liver diseases in children

Oxidative stress, which can be identified as increased exposure to oxidant and/or decreased antioxidant capacities, is widely recognized as a central feature of many diseases. To Identify the importance of oxidant stress in the pathogenesis of chronic liver disease, this study was carried out on 51 children with chronic liver diseases [18 viral hepatitis, 12 bilharzial hepatosplenomegally, 11 glycogen storage disease and 10 Wilson cases] and 15 apparently healthy children as controls. The results showed that, the serum lipid peroxide level in the cases was [5.33 +/- 0.22 nmol / ml which was significantly higher than controls [4, 27 +/- 0.31 nmol/ ml]. While the serum level of vitamin A in patient groups [18.39 +/- 4.98 micro g/ dl] was significantly lower than controls [42.96 +/- 10 ug / dl] At the same time the plasma level of vitamin E in patient groups [253.25 +/- 84.32 ug/dl] was significantly lower than controls [736.86 +/- 74, 4 ug/dl. A significant negative correlation was found between serum lipid peroxide and both of serum vitamin A and plasma vitamin E in all studied patient groups. The significant increase of lipid peroxide and decrease of serum vitamin A and plasma vitamin E as antioxidants, give a good evidence for oxidant stress in children with chronic liver diseases

Recent trend in the pathogenesis of hepatorenal syndrome

33 children aged 6-12 years; 23 with cirrhotic liver; were classified into cirrhotic nonascitic 10 patients [group II], cirrhotic ascitic 8 patients [group III] and cirrhotic ascitic with hepatorenal syndrome 5 patients [group IV]. In addition 10 healthy children as control for this study [group I]. The results showed that the biochemical liver Junction tests were significantly impaired in cirrhotic ascitic patients with HRS as compared to all other groups. Serum creatinine level was significantly high [2.8 +/- 0.34] in group IV as compared to group I [0.82 +/- 0.01], group II [0.77 +/- 0.25] or group III [0.79 +/- 0.2] Group IV showed significant reduction of both serum Na+ [120 +/- 3.2] and urinary Na+ [37 +/- 13.8] when comparaed to all other groups. The plasma level of atrial natriuretic factor in group IV [215.9 +/- 6.27] pg / ml was significantly higher than group I [32.5 +/- 7.5], group II [39.5 +/- 6.95] or group III [188.7 +/- 4.8]. We concluded that a deficiency of atrial natriuretic factor does not appear to cause hepatorenal syndrome as reported before. Elevated atrial natriuretic factor in spite of low urinary Na+ ion group IV [cirrhotic ascitic with HRS] may be an effect rather than a cause of [hepatorenal syndrome] or the kidney is insensitive to the natriureic effect of atrial natriuretic factor