Childhood Liver Disease

Pediatric liver diseases are something of a mystery. Many of them are rare, so it’s hard to gather information about them. They’re notoriously difficult to diagnose, and it’s not clear what causes them.

What is clear is that to the kids who have a liver disease—and to their families—life can be an ordeal. In some cases, children as young as two years old require surgery or even a liver transplant in order to survive. Even when a transplant isn’t necessary, liver disease can impair a child’s ability to eat, sleep, and perform basic functions. Some disorders alter physical appearance and cause intractable itching and skin infections. Abnormalities caused by liver disease can also impair cognitive development and brain and linear growth.

In short, says SPH biostatistician Cathie Spino, “nasty things can happen.” Spino and a team of SPH biostatisticians are serving as the data coordinating center for a series of liver studies being conducted nationwide as part of the National Institutes of Health Children’s Liver Disease Education and Research Network. Trivellore Raghunathan, chair of the SPH biostatistics department, is lead biostatistician for the project. Researchers affiliated with the liver disease network are looking at the genetic determinants of pediatric liver disease as well as at neurodevelopmental milestones, growth, and nutrition. “These are complex diseases,” Spino notes, and because they’re also rare, it’s a challenge to collect and evaluate data.

But as with AIDS, another complex disease she has studied, Spino says it’s possible to get a lot of information from a small number of people, and she’s optimistic the work she and her colleagues are undertaking will lead to new therapeutic approaches for kids who have liver disorders, and to newfound hope for their families.

National Children’s Study Seeks Root Causes of Disease

What role does the environment play in human health and development? That’s the driving question behind the federally funded National Children’s Study, which is planning to follow 100,000+ children in the U.S. from before birth through 21 years of age. SPH biostatistician Michael Elliott and colleagues at Michigan’s major pediatric health research institutions—Michigan State University, UM, Wayne State University, the Henry Ford Health Systems, and the state government—are scheduled to conduct the study in five Michigan counties.

Nationwide, more than 100 counties or groups of counties representing diverse ethnic, racial, economic, religious, geographic, and social groups will be involved in the study—the largest long-term assessment of environmental and genetic influences on children’s health ever conducted in the U.S. By tracking children’s development through infancy, childhood, and early adulthood, researchers hope to determine the root causes of many childhood and adult diseases. Over the next 25 years they’ll be looking at:

  • Air, water, and house dust
  • Asthma
  • Birth defects and pregnancy-related problems
  • Nutrition
  • Injuries
  • Neighborhood safety
  • Frequency of doctor visits
  • Obesity
  • How children are cared for
  • Diabetes
  • Learning and mental health disorders
  • Diet, environment, chemical exposures, and emotional stress during pregnancy