INDIAN CHILDHOOD CIRRHOSIS (ICC) Pathogenesis, Clinical symptoms, Diagnosis and treatment.

icc
icc

Aetiology Factor indian childhood Cirrhosis:

incidence: disease particular to Indian subcontinent with 80% of all cases of cirrhosis in India incidence has come down significantly in recent year.

1) Nutritional

scene age traditional vegetarians are there in poor and malnutrition .

2)viral infection

appears call because of febrile onset and leukocytosis which percent of ICC patient have recent family history of viral hepatitis .

Hepatitis B antigen found in 5 to 20% of cases there is no increased incidence of the disease of the epidemic of viral hepatitis.

3) Genetic:

siblings can be affected reported in many generation and in twins have abnormal Palam print pattern have been noted.

4) toxic:

olfaction more in urine of patient with ICC and in breast milk of their mother herbal medicine containing toxic level of arsenic used mother in pregnancy to change sex of child have been implicated high level of copper demonstrated in liver.

5) immunological:

could be an autoimmune this is auto liver antibodies against intergenic also evidence of primary defect in cell mediated immunity has been found.

Pathogenesis:

liver remains enlargement illness may shrink in terminal stage. organs surface finally granular hard microscopy earliest change balloning.later stage necrosis with reticular system collapse hyline material seen.

clinical feature:

onset: usually in some acute onset with fully minute fatal course. The disease ultimately prove.

early stage:Tere may be history of infective hepatitis is child becomes irritable is of colour and does not play diarrhoea with stickley fever and child has excessive crying in irritable.

intermediate stage: clinical feature more define the child look very ill and maybe frankly abdominal pain. hard liver is always palpable and has a spleen is enlarged mint portal hypertension edema and ankle edema face ascites.

laboratory diagnosis:

Leucocytosis:, Urinary glycosuria, increased juganted bilirubin, elevated alkaline phosphatase,

decrease serum albumin, increase gamma globulins, decrease serum compliment, liver biopsy.

management:

general: diet to balance diet in salt protein, glucose,presence of oedema,and Ascites, vitamin.A.D.K.

prevention:

early case detection by palpations Liver, 3 year old siblings of patients, penicillin lamine in these, case is not causes is not effective because the fibrosed liver has poor capicity for regeneration, avoid use of copper and brass vessels.

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