Liver Disease

The liver is one of the largest organs in a child’s body. The liver performs hundreds of functions, but its primary jobs are to help digest food, store energy, remove harmful substances from your child’s blood, and fight disease.

The liver can be damaged by several diseases and conditions. These include:

• Hepatitis [hep-eh-TYE-tuhs]. Hepatitis is a viral disease that causes inflammation and damage to the liver. There are several types of hepatitis. Children are more likely to get hepatitis A and hepatitis B, but these diseases are becoming less common in children in the U.S. because of vaccinations.
• Autoimmune hepatitis. Autoimmune hepatitis is not caused by a virus, but by a child’s own body. An autoimmune condition is when the body’s immune (disease-fighting) system attacks the body. In this case, the liver cells are attacked. This causes inflammation and damages the liver over time. Autoimmune hepatitis is classified as 1 of the following:
  • Type 1 is the most common type in North America. It can start at any age but most often begins in adolescence (9 to 18 years). It is more common in females and in people who have other autoimmune disorders, such as celiac disease, Crohn’s disease, or lupus.
  • Type 2 occurs less often. Younger children are more likely to get it, especially if they have another autoimmune disorder.
• Nonalcoholic fatty liver disease (NAFLD). While some people get NAFLD for no reason, it is closely tied to obesity and an unhealthy diet. Over time, NAFLD creates swelling and scar tissue (cirrhosis [sur-OH-sis]) in the liver and may lead to liver failure. NASH, which stands for nonalcoholic steatohepatitis [stee-at-uh-hep-uh-TAHY-tis], is a form of nonalcoholic fatty liver disease.
• Inherited liver disease. These are a set of conditions caused by missing or altered genes (sets of specific instructions or “codes” in the body). This might happen because of a family trait or an event that takes place when a baby is just forming in the womb. With inherited diseases, the body is unable to process a particular substance, which keeps the liver and other organs from working properly.
• Liver cancer. Liver cancer is when cancer (malignant) cells form in the liver. Cancer that starts elsewhere in the body and spreads to the liver (metastatic) is not liver cancer.

Liver disease symptoms depend on the type of disease a child has. In some cases, a child may not have any symptoms. Common symptoms associated with 1 or more liver diseases include:

• Yellowing of the eyes and skin (jaundice)
• Chalky (gray) stools
• Nausea and vomiting
• Pain in the upper right part of the belly
• Pain in the joints
• Bloating or swelling in the belly

See your child’s healthcare provider if your child has:

• Any of the symptoms listed above, especially jaundice
• Been exposed to hepatitis
• Symptoms that are not explained by a recent illness or injury
• Symptoms that continue to worsen 

Liver disease causes depend on which type of disease a child has.

For different types of hepatitis, a virus that is spread from person to person in a variety of ways:

• Hepatitis A is caused by the germs found in stool (poop) and is spread by poor sanitation habits like not washing hands. It is usually a temporary (acute) infection that gets better on its own.
• Hepatitis B is passed from 1 infected person to another through bodily fluids, such as semen, blood, or saliva. For example, it can be passed from a mother to her baby during birth, by having unprotected sex with someone who is already infected, or by sharing needles with an infected person. It can be an acute or long-term (chronic) infection.
• Hepatitis C is the most common blood infection in the U.S. Most of the people who have hepatitis C are “baby-boomers” born between 1945 and 1965. It is mainly spread by contact with blood or other bodily fluids from someone who already has the infection.
• Autoimmune hepatitis is a long-lasting disease that can cause cirrhosis and liver failure. Doctors do not yet know the exact cause.

For fatty liver disease: NAFLD is becoming more common in children. It is most often found in kids who:

• Are overweight or obese
• Have prediabetes or type 2 diabetes
• Have high levels of fat in their blood (triglycerides and cholesterol)

Some kids get NAFLD for no known reason.

For inherited liver diseases:

Inherited diseases are passed down from family members or are the result of genetic changes during the early stages of fetal development. In many cases, there is no way to know if a child will get an inherited disease.

For liver cancer:

Liver cancer is most commonly found in kids with:

• Chronic hepatitis B
• Inherited conditions, such as Beckwith-Wiedemann syndrome, hemochromatosis, Trisomy 18
• Very low weight at birth
• Family history of certain liver diseases

To diagnose liver disease, a child’s healthcare provider will likely ask about medical history and perform a physical exam. This may include feeling the child’s abdomen and checking eye color. Depending on  symptoms, the following tests may be ordered:

• Blood tests to check the number of red and white cells and the amount if iron in the blood. They will also test for other substances that may indicate that a child has another medical condition or that a child’s liver is not working correctly.
• Imaging tests to look for problems in the liver, such as an:
  • MRI. This test uses magnets and radio waves to create detailed images of the tissues in a child’s body.
  • Ultrasound. This test uses high-speed sound waves to create images of a child’s organs.
• Biopsy to remove pieces of the liver and/or surrounding tissue to be examined under a microscope.

Treatment for liver disease depends on the type.

For hepatitis, treatment generally includes:

• Taking medicine to relieve symptoms and improve liver function
• Getting plenty of rest to help a child’s body heal
• Maintaining good nutrition and hydration to nourish a child’s body and relieve inflammation in the liver

For autoimmune hepatitis, treatment includes:

• Taking medicines to keep the body from attacking the liver cells and to reduce inflammation in the liver
• Having a liver transplant to replace a liver that is not working properly

For NAFLD, treatment can often include:

• Eating a healthy diet
• Exercising regularly
• Losing weight if recommended by your child’s healthcare provider
• Lowering cholesterol and triglyceride levels
• Controlling diabetes (if present)
• Taking medicines or specific nutritional supplements

For any inherited diseases and conditions, treatment depends on the type and severity.

For liver cancer, treatment depends on the type and severity, including:

• Surgery. It may be necessary to remove part of the liver. The tissue that is left will continue to support the needs of the body and may regrow.
• Transplant. A child may be able to get a transplant if the cancer has not spread outside of the liver.
• Medicines. Cancer-fighting medicines can be used to target specific cells. The medicine finds and attacks the type of cell it is designed to fight.
• Radiation. High-intensity x-rays are used to shrink or kill tumors or to keep them from spreading.

Prevent child and adult hepatitis by:

• Getting vaccinated for hepatitis A and hepatitis B
• Washing hands and teaching children to wash their hands before eating and after going to the bathroom or changing a diaper
• Practicing safe sex
• Not sharing needles, razors, or toothbrushes

There is no known way to prevent autoimmune hepatitis.

Prevent fatty liver disease by:

• Eating lots of fresh fruits and vegetables
• Getting regular exercise
• Avoiding alcohol
• Lowering cholesterol

There is no known way to prevent most inherited diseases.

Prevent liver cancer by following the prevention recommendations for all liver disease. Long-term complications from liver disease increase a child’s risk of getting liver cancer.

American Liver Foundation

American Liver Foundation

MedlinePlus

National Cancer Institute

NIDDK

The liver is one of the largest organs in a child’s body. Its job is to help digest food, store energy, and remove harmful substances from the blood. It performs many important functions, but can be damaged by conditions, such as hepatitis, fatty liver disease, other medical conditions, and inherited conditions. Long-term damage to the liver can cause serious complications and may require a liver transplant. Learn more about liver disease.