Pediatric Liver Disease in the Asian Continent

  • Anshu Srivastava
  • Rishi Bolia


South and East Asia is home to around 50% of the world’s population. The pattern of liver diseases in terms of epidemiology, clinical manifestations and outcomes in this region is different from the Western world. Increased infections, malnutrition, poor sanitation, difference in genetic make-up and inadequate access to healthcare facilities are the reasons for this difference.

Viral hepatitis is endemic. While hepatitis A and E viruses are the most common causes of acute hepatitis and liver failure, hepatitis B virus is a common cause of chronic liver disease. Infections like malaria, dengue and typhoid fever often masquerade as acute liver failure. Hepatobiliary infections like liver abscesses and hydatid cyst are important causes of morbidity. Biliary atresia and other metabolic liver diseases are often diagnosed late due to delay in referral, leading to a poor outcome. Alpha 1 antitrypsin deficiency is rarely encountered in this region, while citrin deficiency, Indian childhood cirrhosis and Budd–Chiari syndrome are more common. Unlike the west, where cirrhosis is the commonest cause, extrahepatic portal vein obstruction is the commonest aetiology for portal hypertension. Delay in diagnosis and non-availability of transplantation account for the large number of children with end-stage liver disease and its complications like ascites, spontaneous bacterial peritonitis, variceal bleeding and hepatic encephalopathy. Liver transplantation is mainly living donor-related, and it is not accessible to a large proportion of the population because of financial constraints and a lack of expertise.

There is an urgent need to have multidimensional collaboration between the developed and developing world and research in diseases more prevalent in this region to improve the quality of care and outcome of children with liver disease at a global level.


South Asia East Asia Southeast Asia Children Liver diseases 



α1-antitrypsin deficiency


Acute on chronic liver disease


Acute-on-chronic liver failure


Autoimmune hepatitis


Amoebic liver abscess


Acute liver failure


Alanine aminotransferase


Asian Pacific Association for the Study of the Liver


Antitubercular therapy


Acute viral hepatitis


Biliary atresia


Budd–Chiari syndrome


Body mass index


Complementary and alternative medicine


Common bile duct


Chronic hepatitis C


Chronic liver disease


Culture-negative neutrocytic ascites


Citrullinemia type II


Directly acting antivirals


Deceased donor liver transplantation


Dengue haemorrhagic fever


Drug-induced liver injury


Extrahepatic portal venous obstruction


Endoscopic retrograde cholangiopancreatography


End-stage liver disease


Failure to thrive and dyslipidemia caused by citrin deficiency


Hepatitis A virus


Hepatitis B e antigen


Hepatitis B surface antigen


Hepatitis B virus


Hepatocellular carcinoma


Hepatitis C virus


Hepatitis E virus


Hepatic veins


Indian childhood cirrhosis


Idiopathic portal hypertension


Inferior vena cava


Living donor liver transplantation


Liver function tests


Molecular adsorbent recirculating system


Medium-chain triglyceride


Mesenterico-left portal vein bypass


Non-alcoholic fatty liver disease


Neonatal cholestasis


Non-cirrhotic portal fibrosis


Neonatal intrahepatic cholestasis caused by citrin deficiency


Percutaneous aspiration injection and re-aspiration


Progressive familial intrahepatic cholestasis


Portal hypertension


Pyogenic liver abscess


Spontaneous bacterial peritonitis


South-East Asia Region


Transjugular intrahepatic portosystemic shunt


Urinary tract infection


Wilson’s disease


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Anshu Srivastava
    • 1
  • Rishi Bolia
    • 1
  1. 1.Department of Pediatric GastroenterologySanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia

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