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Abstract -2n- S tlIoII4ARY ------ Chronic liver disease in Egyptian children is one of the leading oauses of morbidity and mortality in Egypt. This study was carried out on 45 children aged between 2 years and 14 years including 30 males, 15 females and 15 nomal control children of the sameage group (11 males and 4 females). Theywere selected fram patients~ admitted to El-Mounira children Hospital Cairo University in the year 1982 end 1983. The main presenting features was hepatomegaly of somemonths duration. Their history, physical ecamination and investigations were carried out we pay muchattention to the Enzymaticaotivity in the serum and its Correlation with both clinical and histopathological studies of the patients. Aocordingto histopathological findings the cases were classified into the following 5 subgroups• .. _. __.._--~------~ -272- Chronio aotive hepatitis 9 oases (2~) Post-hepatitio oirrhosis 11 oases(24.4%) Veno-ooo~uaivedisease 6 oases(~J.J%) 14. Pure-bilharzial hepatio fibrosis 12 oases(26.7%) 15. Mixed (Shistosamiasis and other lesions) 7 oases(15.6%) Each group was studied separately for its olinical Ipioture and its oorreletion to both histopathological &: Ibiochemical investigations with laying an stress on Ithe statisti~ analysis of biochemical resuJ.tSI II. Chronic active group (20%). ------------------------- The biochemi~ p:r;’ofile suggesting the diagnosis I:lfC.A.H. according to our findings were I i- Serum transaminasss SGOTand SGPTincreased by 4.5 - e folds the normal. !- Total serum protein was elevated. !- MarkedhypergammaglobuJ.inaemiaby J folds of normal mean. Serum bilirubin was increased by 2 folds of normal range with the mean of l.J;t0.8 DIg %. -273- - Alkaline phosphatase was increased only by l2 fold of normal level. - Serum L.D.H. was increased by about 3 folds ot normal level. - Serum GGT was found about 2.75 folds of normal level. II. Post-hepatitic cirrhosis (22.4%) -------------------------------- The biochemical profile suggesting the diagnosis of P.H.C. according to our tindings were: - Mean serum albumin was 50% lower than the normal mean level. - ””’-2 globulin ot protein eJectrophoresis was increased above normal range. B globulin levels were found either slightly increased or within the normal range. - Gammaglobulin level in protein electrophoresis wes elevated by more than 2 folds of the normal level. - Serum bilirubin was increased by about 2.75 folds ot normal level. -274- - Serumalalille phospatase was either withill the normal level or very slightly inoreased. - Serum transaminases were found to be illcreased by 2 folds of normal. - Serum GGTiwas increased by about 3 folds of normal level. III. Veno-ooclusive disease(13.)%) The biochemical profile suggestillg the diagnosis o:e V.O.D. according to our findings were I - MeanSGPTlevel was almost no:rmal. - MeanSGOTlevel was mildly elevated. Meantotal serum protein levels were decreased by 25% below the normal level. - Meanserum albumill was below normal by about 25% ofnnormal level. - Mean.,,’\ globulin was markedly d1millished by about 90%of the normal level. - Serum gammaglobulill was normal. Serum bilirubill was moderatly illcreased by 2 folds of normal level. - 75- - Serum L.D.H. was very sligJatly increased or about nonnal. - Serum GGTwas high by about J folds of normal level. lY. Pure hepatic schistos iasis (26.7%) --------------------- ------------- The biochemical profi e suggesting the diagnosis 0:[ pure hepatic schistosomi ses aocording to our find: Lngswerel - Total serum protein decreased. d serum albumin were Serum c<. 1 • 00<. 2 and B globulin were at normal leve],. - Serum gamma globulin of the normal level. s increased by 2 folds Serum transeminases w re elevated by about ~ folds of normal in SGT and 5.5 folds of normal level in SGOT. - Slight elevation of a 1.75 folds of normal. line phosphatase by - SerumGGTactivity wa elevated to more than J folds of normal lev 1. -216- IV. Hepatio bilharzial fibrosis with other lesions ---------------------------------------------- (mixed type) (15.6%) ---------------------- The bioohemical profile suggesting the diagnosis cf hepatio bilharzial fibrosis with other hepatitis lesion aooording to our findings werea •. Marked elevation of both SGPT(meanlevel more than 1folds of normal level) and SOOT(mean level was more than 12 folds of normal level). •. Total serum protein levels were near normal level. •. B-globulin mean level was J~ below normal level. •• Serumgammaglobulinwas increased by 2.5 folds of normal level. •• Serumalkaline phosphatase was inoreased by 1.15 folds of normal• •, SertunLDII& SerumGGTwere inoreased above normal by 2.5 and 3.5 folds of normal in Sequenoe. Out of these study we can ooncluded that it is possible to gain a great value from biochemical tests to confirm the diagnosis of chronio hepatio insult beside -277- the findings of histopatho~ogica~ biopsies. It is very important to knowthe exaot level of serum enzymesof dUferent diseases re~at1ve to the norma~~eve~. It is either above normaJ.level t nODial or subnorma~by adefinite numberof fo~ds• |