Spectrum of liver disease in a cohort of adult Sri Lankans admitted to a medical unit in a tertiary referral center- a ten month survey based on histology

Abstract

OBJECTIVE: To study the pattern of chronic liver cell disease in adult Sri Lankans seeking medical advise in a tertiary referral centre. Data of such diseases remain largely unevaluated in Sri Lanka with scanty data from South East Asia for comparison. DESIGN, SETTING AND METHODS: Case notes of sixty consecutive patients having clinical and investigative abnormalities suggestive of liver disease over a six month period, subjected to consented liver biopsy (selection-biased sample) from 01.12.2004 to 01.10.2005 were retrospectively analyzed. RESULTS: The study group had an age range of 20 to 80 years with a male: female sex ratio of 53:7 (8:1). 41.7% were in the 51-60 years age group, males constituting 92%. Histology revealed cirrhosis, fatty liver, non-alcoholic steatohepatitis (NASH) and hepatocellular carcinoma in 35(59%), 12 (20%), 11(18%) and 2(3%) respectively. At presentation, 71% had evidence of hepatomegaly clinically or ultrasonic ally. Non-alcoholic group constituted 66.6% with male:female ratio of 35:5(7:1), while in alcoholics it was 24:1. NASH group had an age range of 25-55 years with a mean age of 3S+/-2 SD years. Male: female ratio is 10:8. BM1, AST, ALT, ALP showed mean values of 25.2 kg/nr, 86.7+7-15.2 IU/L, 93.21+/-16.3 IU/L and 251.0+/-18.1 IU/L respectively. Hepatitis B and C serology were negative in all. CONCLUSIONS: Amongst current chronic liver cell diseases, non-alcoholic group constitutes the greatest challenge for the future, which merit multi center in-depth studies. Hepatitis B and hepatitis C infections seem to be unimportant aetiological factors.