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Juvenile Cirrhosis: A Clinico pathologic Study of Twenty-Seven Cases

Juvenile Cirrhosis: A Clinico pathologic Study of Twenty-Seven Cases Abstract The pathogenesis of hepatic cirrhosis has been in dispute since Laennec first wrote his account of the disease in 1819. The many studies made to solve this problem attest to its difficulty. This difficulty of determining pathogenesis has been as great for the juvenile form as it has been for the adult form of the disease. In order to contribute to our knowledge of the pathogenesis and other aspects of juvenile cirrhosis, all cases studied at the Mayo Clinic which had pathologic verification were reviewed and a careful study was made of the clinical and pathologic aspects of the disease. Some of the cases previously studied by Perozzi have been included. Material and Methods Cirrhosis is defined as that condition of the liver which fulfills the following criteria: (1) degeneration of hepatic cells, (2) increase in connective tissue, and (3) the presence of nodular regeneration with distortion of the vascular References 1. Baggenstoss, A. H., and Stauffer, M. H.: Posthepatitic and Alcoholic Cirrhosis: Clinicopathologic Study of 43 Cases of Each , Gastroenterology 22:157-180 ( (Oct.) ) 1952. 2. Baxter, J. H., and Ashworth, C. T.: Renal Lesions in Portal Cirrhosis , Arch. Path. 41:476-488 ( (May) ) 1946. 3. Bellin, L. B., and Bailit, I. W.: Congenital Cirrhosis of the Liver Associated with Infectious Hepatitis of Pregnancy , J. Pediat. 40:60-63 ( (Jan.) ) 1952.Crossref 4. Bergstrand, H.: Über die akute und chronische gelbe Leberatrophie mit besonderer Berücksichtigung ihres epidemischen Auftretens in Schweden im Jahre 1927 , Leipzig, Georg Thieme, 1930. 5. Bjørneboe, M., and Raaschou, F.: The Pathology of Subchronic Atrophy of the Liver: A Comparison with Cirrhosis Hepatis Laennec , Acta med. scandinav. , (Supp. 234) , pp. 41-62, 1949. 6. Bright, R., and Addison, T., cited by Dible, J. H.: Degeneration, Necrosis, and Fibrosis in the Liver , Brit. M. J. 1:833-841 ( (April 21) ) 1951.Crossref 7. Cattan, R.; Sebouk, S., and Habib, R.: Le Rein des cirrhotiques (confrontation anatomoclinique) , Semaine hôp. Paris 30:252-257 ( (Jan. 20) ) 1954. 8. Coppoletta, J. M., and Wolbach, S. B.: Body Length and Organ Weights of Infants and Children: A Study of the Body Length and Normal Weights of the More Important Vital Organs of the Body Between Birth and 12 Years of Age , Am. J. Path. 9:55-70 ( (Jan.) ) 1933. 9. Craig, J. M.; Gellis, S. S., and Hsia, D. Y.: Cirrhosis of the Liver in Infants and Children , A. M. A. Am. J. Dis. Child. 90:299-322 ( (Sept.) ) 1955. 10. Craig, J. M., and Landing, B. H.: Form of Hepatitis in Neonatal Period Simulating Biliary Atresia , A. M. A. Arch. Path. 54:321-333 ( (Oct.) ) 1952. 11. Crowson, C. N., and More, R. H.: Glomerulotubular Nephrosis Correlated with Hepatic Lesions: II. Incidence and Morphology of Associated Kidney and Liver Lesions in Human Autopsy Material , A. M. A. Arch. Path. 60:73-84 ( (July) ) 1955. 12. Dible, J. H.; Hunt, W. E.; Pugh, V. W.; Steingold, L., and Wood, J. H. F.: Foetal and Neonatal Hepatitis and Its Sequelae , J. Path. & Bact. 67:195-206 ( (Jan.) ) 1954. 13. Dible, J. H.; McMichael, J., and Sherlock, S. P. V.: Pathology of Acute Hepatitis: Aspiration Biopsy Studies of Epidemic, Arsenotherapy and Serum Jaundice , Lancet 2:402-408 ( (Oct. 2) ) 1943. 14. Elias, M. H.: Morphology of the Liver , in Transactions of the Eleventh Conference on Liver Injury , edited by F. W. Hoffbauer, New York, Josiah Macy, Jr. Foundation, 1952, pp. 111-199. 15. Howard, R., and Watson, C. J.: Antecedent Jaundice in Cirrhosis of the Liver , Arch. Int. Med. 80:1-10 ( (July) ) 1947. 16. Jones, C. M., and Minot, G. R.: Infectious (Catarrhal) Jaundice: An Attempt to Establish a Clinical Entity , Boston M. & S. J. 189:531-551 ( (Oct. 18) ) 1923. 17. Karsner, H. T.: Discussion , in Transactions of the Sixth Conference on Liver Injury , edited by F. W. Hoffbauer, New York, Josiah Macy, Jr. Foundation, 1947, pp. 13-14. 18. Krarup, N. B., and Roholm, K.: The Development of Cirrhosis of the Liver After Acute Hepatitis, Elucidated by Aspiration Biopsy , Acta med. scandinav. 108:306-331, 1941. 19. Kunkel, H. G., and Labby, D. H.: Chronic Liver Disease Following Infectious Hepatitis: Cirrhosis of the Liver , Ann. Int. Med. 32:433-450 ( (March) ) 1950. 20. Laurie, W. S.: Hepatic Cirrhosis with Splenomegaly in Children , M. J. Australia l:178-179 ( (Feb. 9) ) 1935. 21. Lichtman, S. S.: Diseases of the Liver, Gallbladder and Bile Ducts , Ed. 3, Philadelphia, Lea & Febiger, 1953. 22. Mallory, F. B.: Cirrhosis of the Liver: Five Different Types of Lesions from Which It May Arise , Bull. Johns Hopkins Hosp. 22:69-75 ( (March) ) 1911. 23. Mann, F. C., and Magath, T. B.: The Production of Chronic Liver Insufficiency , Am. J. Physiol. 59:485 ( (Feb.) ) 1922. 24. Marchand, F.: Über Ausgang der acuten Leberatrophie in multiple knotige Hyperplasie , Beitr. path. Anat. 17:206-219, 1895. 25. Moschcowitz, E.: The Pathogenesis of Splenomegaly in Hypertension of the Portal Circulation: "Congestive Splenomegaly ," Medicine 27:187-221 ( (May) ) 1948. 26. Patek, A. J., Jr.; Seegal, D., and Bevans, M.: The Coexistence of Cirrhosis of the Liver and Glomerulonephritis: Report of 14 Cases , Am. J. M. Sc. 221:77-85 ( (Jan.) ) 1951.Crossref 27. Perkins, R. F.; Baggenstoss, A. H., and Snell, A. M.: Viral Hepatitis as a Cause of Atrophy and Cirrhosis of the Liver , Proc. Staff Meet., Mayo Clin. 25:287-298 ( (May 24) ) 1950. 28. Perozzi, T.: Juvenile Cirrhosis, Thesis, Graduate School, University of Minnesota, 1938. 29. Popper, H.: Liver Disease—Morphologic Considerations , Am. J. Med. 16:98-117 ( (Jan.) ) 1954.Crossref 30. Post, J.; Gellis, S., and Lindenauer, H. J.: Studies on the Sequelae of Acute Infectious Hepatitis , Ann. Int. Med. 33:1378-1397 ( (Dec.) ) 1950.Crossref 31. Schindler, J. A., and Kindschi, L. G.: Juvenile Cirrhosis of the Liver in 3 Members of the Same Family , Wisconsin M. J. 50:1004-1008 ( (Oct.) ) 1951. 32. Sheldon, W. H., and James, D. F.: Cirrhosis Following Infectious Hepatitis: A Report of 5 Cases, in 2 of Which There Was Superimposed Primary Liver Cell Carcinoma , Arch. Int. Med. 81:666-689 ( (May) ) 1948.Crossref 33. Stauffer, M. H.: Needle Biopsy of the Liver, Thesis, Graduate School, University of Minnesota, 1950. 34. Stokes, J., Jr.; Wolman, I. J.; Blanchard, M. C., and Farquhar, J. D.: Viral Hepatitis in the Newborn: Clinical Features, Epidemiology, and Pathology , A. M. A. Am. J. Dis. Child. 82:213 ( (Aug.) ) 1951. 35. Thaler, H.: Über die formale Pathogenese der posthepatitischen Lebercirrhose , Beitr. path. Anat. 112:173-186 ( (March) ) 1952. 36. Volwiler, W., and Elliott, J. A., Jr.: Late Manifestations of Epidemic Infectious Hepatitis , Gastroenterology 10:349-365 ( (March) ) 1948. 37. Waldstein, S. S., and Szanto, P. B.: Accuracy of Sampling by Needle Biopsy in Diffuse Liver Disease , Arch. Path. 50:326-328 ( (Sept.) ) 1950. 38. Watson, C. J., and Hoffbauer, F. W.: The Problem of Prolonged Hepatitis with Particular Reference to the Cholangiolitic Type and to the Development of Cholangiolitic Cirrhosis of the Liver , Ann. Int. Med. 25:195-227 ( (Aug.) ) 1946.Crossref 39. Yazigi, R.; Armas-Cruz, R.; Silva, S., and Ossandon, M.: Fibrosis and Nodular Hyperplasia of the Liver (Post-Necrotic Cirrhosis): Clinical and Pathological Study of 9 Cases , Gastroenterology 18:587-597 ( (Aug.) ) 1951. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Journal of Diseases of Children American Medical Association

Juvenile Cirrhosis: A Clinico pathologic Study of Twenty-Seven Cases

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American Medical Association
Copyright
Copyright © 1957 American Medical Association. All Rights Reserved.
ISSN
0096-6916
DOI
10.1001/archpedi.1957.04030020066012
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Abstract

Abstract The pathogenesis of hepatic cirrhosis has been in dispute since Laennec first wrote his account of the disease in 1819. The many studies made to solve this problem attest to its difficulty. This difficulty of determining pathogenesis has been as great for the juvenile form as it has been for the adult form of the disease. In order to contribute to our knowledge of the pathogenesis and other aspects of juvenile cirrhosis, all cases studied at the Mayo Clinic which had pathologic verification were reviewed and a careful study was made of the clinical and pathologic aspects of the disease. Some of the cases previously studied by Perozzi have been included. Material and Methods Cirrhosis is defined as that condition of the liver which fulfills the following criteria: (1) degeneration of hepatic cells, (2) increase in connective tissue, and (3) the presence of nodular regeneration with distortion of the vascular References 1. Baggenstoss, A. H., and Stauffer, M. H.: Posthepatitic and Alcoholic Cirrhosis: Clinicopathologic Study of 43 Cases of Each , Gastroenterology 22:157-180 ( (Oct.) ) 1952. 2. Baxter, J. H., and Ashworth, C. T.: Renal Lesions in Portal Cirrhosis , Arch. Path. 41:476-488 ( (May) ) 1946. 3. Bellin, L. B., and Bailit, I. W.: Congenital Cirrhosis of the Liver Associated with Infectious Hepatitis of Pregnancy , J. Pediat. 40:60-63 ( (Jan.) ) 1952.Crossref 4. Bergstrand, H.: Über die akute und chronische gelbe Leberatrophie mit besonderer Berücksichtigung ihres epidemischen Auftretens in Schweden im Jahre 1927 , Leipzig, Georg Thieme, 1930. 5. Bjørneboe, M., and Raaschou, F.: The Pathology of Subchronic Atrophy of the Liver: A Comparison with Cirrhosis Hepatis Laennec , Acta med. scandinav. , (Supp. 234) , pp. 41-62, 1949. 6. Bright, R., and Addison, T., cited by Dible, J. H.: Degeneration, Necrosis, and Fibrosis in the Liver , Brit. M. J. 1:833-841 ( (April 21) ) 1951.Crossref 7. Cattan, R.; Sebouk, S., and Habib, R.: Le Rein des cirrhotiques (confrontation anatomoclinique) , Semaine hôp. Paris 30:252-257 ( (Jan. 20) ) 1954. 8. Coppoletta, J. M., and Wolbach, S. B.: Body Length and Organ Weights of Infants and Children: A Study of the Body Length and Normal Weights of the More Important Vital Organs of the Body Between Birth and 12 Years of Age , Am. J. Path. 9:55-70 ( (Jan.) ) 1933. 9. Craig, J. M.; Gellis, S. S., and Hsia, D. Y.: Cirrhosis of the Liver in Infants and Children , A. M. A. Am. J. Dis. Child. 90:299-322 ( (Sept.) ) 1955. 10. Craig, J. M., and Landing, B. H.: Form of Hepatitis in Neonatal Period Simulating Biliary Atresia , A. M. A. Arch. Path. 54:321-333 ( (Oct.) ) 1952. 11. Crowson, C. N., and More, R. H.: Glomerulotubular Nephrosis Correlated with Hepatic Lesions: II. Incidence and Morphology of Associated Kidney and Liver Lesions in Human Autopsy Material , A. M. A. Arch. Path. 60:73-84 ( (July) ) 1955. 12. Dible, J. H.; Hunt, W. E.; Pugh, V. W.; Steingold, L., and Wood, J. H. F.: Foetal and Neonatal Hepatitis and Its Sequelae , J. Path. & Bact. 67:195-206 ( (Jan.) ) 1954. 13. Dible, J. H.; McMichael, J., and Sherlock, S. P. V.: Pathology of Acute Hepatitis: Aspiration Biopsy Studies of Epidemic, Arsenotherapy and Serum Jaundice , Lancet 2:402-408 ( (Oct. 2) ) 1943. 14. Elias, M. H.: Morphology of the Liver , in Transactions of the Eleventh Conference on Liver Injury , edited by F. W. Hoffbauer, New York, Josiah Macy, Jr. Foundation, 1952, pp. 111-199. 15. Howard, R., and Watson, C. J.: Antecedent Jaundice in Cirrhosis of the Liver , Arch. Int. Med. 80:1-10 ( (July) ) 1947. 16. Jones, C. M., and Minot, G. R.: Infectious (Catarrhal) Jaundice: An Attempt to Establish a Clinical Entity , Boston M. & S. J. 189:531-551 ( (Oct. 18) ) 1923. 17. Karsner, H. T.: Discussion , in Transactions of the Sixth Conference on Liver Injury , edited by F. W. Hoffbauer, New York, Josiah Macy, Jr. Foundation, 1947, pp. 13-14. 18. Krarup, N. B., and Roholm, K.: The Development of Cirrhosis of the Liver After Acute Hepatitis, Elucidated by Aspiration Biopsy , Acta med. scandinav. 108:306-331, 1941. 19. Kunkel, H. G., and Labby, D. H.: Chronic Liver Disease Following Infectious Hepatitis: Cirrhosis of the Liver , Ann. Int. Med. 32:433-450 ( (March) ) 1950. 20. Laurie, W. S.: Hepatic Cirrhosis with Splenomegaly in Children , M. J. Australia l:178-179 ( (Feb. 9) ) 1935. 21. Lichtman, S. S.: Diseases of the Liver, Gallbladder and Bile Ducts , Ed. 3, Philadelphia, Lea & Febiger, 1953. 22. Mallory, F. B.: Cirrhosis of the Liver: Five Different Types of Lesions from Which It May Arise , Bull. Johns Hopkins Hosp. 22:69-75 ( (March) ) 1911. 23. Mann, F. C., and Magath, T. B.: The Production of Chronic Liver Insufficiency , Am. J. Physiol. 59:485 ( (Feb.) ) 1922. 24. Marchand, F.: Über Ausgang der acuten Leberatrophie in multiple knotige Hyperplasie , Beitr. path. Anat. 17:206-219, 1895. 25. Moschcowitz, E.: The Pathogenesis of Splenomegaly in Hypertension of the Portal Circulation: "Congestive Splenomegaly ," Medicine 27:187-221 ( (May) ) 1948. 26. Patek, A. J., Jr.; Seegal, D., and Bevans, M.: The Coexistence of Cirrhosis of the Liver and Glomerulonephritis: Report of 14 Cases , Am. J. M. Sc. 221:77-85 ( (Jan.) ) 1951.Crossref 27. Perkins, R. F.; Baggenstoss, A. H., and Snell, A. M.: Viral Hepatitis as a Cause of Atrophy and Cirrhosis of the Liver , Proc. Staff Meet., Mayo Clin. 25:287-298 ( (May 24) ) 1950. 28. Perozzi, T.: Juvenile Cirrhosis, Thesis, Graduate School, University of Minnesota, 1938. 29. Popper, H.: Liver Disease—Morphologic Considerations , Am. J. Med. 16:98-117 ( (Jan.) ) 1954.Crossref 30. Post, J.; Gellis, S., and Lindenauer, H. J.: Studies on the Sequelae of Acute Infectious Hepatitis , Ann. Int. Med. 33:1378-1397 ( (Dec.) ) 1950.Crossref 31. Schindler, J. A., and Kindschi, L. G.: Juvenile Cirrhosis of the Liver in 3 Members of the Same Family , Wisconsin M. J. 50:1004-1008 ( (Oct.) ) 1951. 32. Sheldon, W. H., and James, D. F.: Cirrhosis Following Infectious Hepatitis: A Report of 5 Cases, in 2 of Which There Was Superimposed Primary Liver Cell Carcinoma , Arch. Int. Med. 81:666-689 ( (May) ) 1948.Crossref 33. Stauffer, M. H.: Needle Biopsy of the Liver, Thesis, Graduate School, University of Minnesota, 1950. 34. Stokes, J., Jr.; Wolman, I. J.; Blanchard, M. C., and Farquhar, J. D.: Viral Hepatitis in the Newborn: Clinical Features, Epidemiology, and Pathology , A. M. A. Am. J. Dis. Child. 82:213 ( (Aug.) ) 1951. 35. Thaler, H.: Über die formale Pathogenese der posthepatitischen Lebercirrhose , Beitr. path. Anat. 112:173-186 ( (March) ) 1952. 36. Volwiler, W., and Elliott, J. A., Jr.: Late Manifestations of Epidemic Infectious Hepatitis , Gastroenterology 10:349-365 ( (March) ) 1948. 37. Waldstein, S. S., and Szanto, P. B.: Accuracy of Sampling by Needle Biopsy in Diffuse Liver Disease , Arch. Path. 50:326-328 ( (Sept.) ) 1950. 38. Watson, C. J., and Hoffbauer, F. W.: The Problem of Prolonged Hepatitis with Particular Reference to the Cholangiolitic Type and to the Development of Cholangiolitic Cirrhosis of the Liver , Ann. Int. Med. 25:195-227 ( (Aug.) ) 1946.Crossref 39. Yazigi, R.; Armas-Cruz, R.; Silva, S., and Ossandon, M.: Fibrosis and Nodular Hyperplasia of the Liver (Post-Necrotic Cirrhosis): Clinical and Pathological Study of 9 Cases , Gastroenterology 18:587-597 ( (Aug.) ) 1951.

Journal

A.M.A. Journal of Diseases of ChildrenAmerican Medical Association

Published: Jul 1, 1957

References