VALUE OF COLCHICINE IN PEDIATTRIC HEPATIC FIBROSIS / CIRRHOSIS

Abstract

Hepatic fibrosis occurs as a consequence of net accumulation of matrix protein. Such fibrosis is associated with an increase in both collagen content and synthesis rate.

Investigator now have an array of molecular' and imrimnological reagents for monitoring matrix metabolism. The observation that some forms of hepatic fibrosis were reversible, together with the appreciated knowledge of the dynamicity of the process of fibrosis, justified the testing of many antifibrotic agents in cases of hepatic fibrosis. Preliminary evidence that colchicine a,s an inhibitor of collagen synthesis may be beneficial in he treatment of liver cirrhosis have been reported by many authors. The aim of this work was to assess the reversibility of hepatic fibrosis in children after the use of colchicine therapy by determination of serum PIIINP, plasma fibronectin and tissue collagen III as a parameters of hepatic fibrosis. Thirty five patients suffering from chronic liver disease admitted to Abou El-Reich pediatric hepatology clinic were given cholchicine at a dose of 15 micrograms/ kilogram /day.

Patients were assessed before and after therapy by clinical evaluation, hematological assessment, liver function tests, abdominal ultra sonographic scanning, upper and lower endoscopic examination as needed. Estimation of serum PIIINP, plasma .fibronectin, liver biopsy and tissue collagen type III after 6 months of therapy. The changes that have occurred at the end of the follow - up period were documented and analyzed.