Etiology of cirrhosis in the young

Maria C. Olave, Ananta Gurung, Pramod K. Mistry, Sanjay Kakar, Matthew Yeh, Min Xu, Tsung Teh Wu, Michael Torbenson, Dhanpat Jain

Research output: Contribution to journalArticlepeer-review


The etiology and incidence of cirrhosis in adults has been well studied, however there is scant data in younger patients. The aim of this study was to determine causes of cirrhosis in patients ≤40 years old. In this multi-institutional retrospective study, pathology databases were searched for patients ≤40-year-old with a diagnosis of cirrhosis from 1995 to 2018. Clinical charts and pathology reports were reviewed to identify etiologies of cirrhosis in each case. The patients were divided into 4 age groups (<1, 1- < 5, 5- < 18, and 18–40 years old) for further analysis. We identified 594 patients (264 female, 330 male). Among <18-year-old patients, congenital cholestatic diseases and developmental disorders were the most common causes of cirrhosis (50.2%, 172/342). Metabolic and genetic diseases were also seen more commonly in this age group (16.6%, 57/342). In contrast, viral hepatitides were the most common cause of cirrhosis in 18–40-year-old patients (39.6%, 100/252) followed by autoimmune and fatty liver disease (22.2%, 56/252 and 15.07%, 38/252, respectively). Cryptogenic cirrhosis (overall 7.2%, 42/594) was seen in 3% (4/133), 1.4% (1/69), 10.7% (15/140) and 8.7% (22/252) of patients aged <1, 1- < 5, 5- < 18, and 18–40 years, respectively. Developmental and metabolic disorders are the most common causes of cirrhosis in children (<18), while viral hepatitides are leading causes in adolescents and young adults (18–40) similar to adults. The incidence of cryptogenic cirrhosis also varies depending on the age, being lowest in 1- < 5 year and highest in 5- < 18 year age group children.

Original languageEnglish (US)
Pages (from-to)96-103
Number of pages8
JournalHuman Pathology
StatePublished - Feb 2020


  • Cirrhosis
  • Cryptogenic Cirrhosis
  • Epidemiology
  • Etiology
  • Young Adults

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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