CC: Room 214/216
With a focus on liver disease that originates in the perinatal period, particularly in the interactions between mother and infant, Friday’s AASLD/NASPGHAN Pediatric Symposium at noon in Room 214/216, Moscone North/South, will address issues applicable not only for the pediatric hepatologist, but the adult hepatologist who takes care of pregnant women.
“Some of the concepts are emerging, especially the role of nonalcoholic fatty liver disease (NAFLD) in pregnancy and the development of severe fatty liver disease phenotype in children with the epidemic of fatty liver disease and obesity that we’re seeing,” said symposium co-chair Samar H. Ibrahim, MB, ChB, Assistant Professor of Pediatrics at Mayo Clinic.
Co-Chair Saeed Mohammad, MD, Associate Professor of Pediatrics, Northwestern University Feinberg School of Medicine, added that while they want to keep the symposium focused on pediatrics, the content of this year’s program is applicable to adult providers as well.
“If you look at the first half of the program, the talks are geared toward the neonate and pregnancy. We have a talk on liver failure in early infancy. It’s an urgent medical condition that requires the involvement of a multidisciplinary team, so we have neonatologists and obstetricians who are involved in the management; then with fatty liver of pregnancy, again obstetricians are involved; with the metabolic disorders, you have geneticists, metabolic specialists and hepatologists all involved,” said Dr. Mohammad.
The symposium will address advances made in the diagnosis of neonatal liver failure/dysfunction and the broadened differential. It will also discuss prenatal interventions to improve the outcome of newborns and infants at risk and will highlight the recent advances in postnatal therapies. Finally, the symposium will increase awareness of the developmental origin of NAFLD and available prenatal interventions.
“There are a lot of clinical pearls that are going to be presented and some of what we call best practice,” said Dr. Ibrahim. “There are some clinical tools, but at the same time there will be more about what’s on the horizon, what we should do next, and how we can address things that are not really acute, but might pose a problem in our children in the long term, like fatty liver disease.”
Both chairs are particularly excited about the talks on genetic, mitochondrial and metabolic disorders and gestational allo-immune liver disease.
“In early infancy, kids usually present in about the same way for many different diseases,” said Dr. Mohammad. “It’s important to broaden the clinical differential for sick infants to not only infections but also a genetic or metabolic liver disease.”
He noted that while the consensus may be that genetic testing is expensive, difficult and time consuming, they are are getting cheaper and faster.
“There are some that may be worthwhile sending as early as possible so that you can diagnose patients who have a liver dysfunction,” he added.
Dr. Ibrahim said that precision medicine comes into play with many of these patients as more and more whole exome sequencing occurs for these disorders.
“There’s more ways to identify unknown disease causing mutations this way. So this is one of the things that they will see in the genetic, mitochondrial, metabolic disorders section of the program,” she said.