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A. MYRON JOHNSON, MD
Department of Pediatrics University of North Carolina Chapel Hill, NC 27514

Am J Dis Child. 1973;126(6):861.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—The optimism expressed by Talamo and Feingold¹ regarding the prognosis in children with hepatocellular disease and Pi ZZ ₁-antitrypsin must be tempered with a note of caution. As Alper and I reported previously,² many of these children do improve clinically after the initial, neonatal illness. In fact, over half of the patients we have observed have had "remissions" of months to years, although most have had minimal biochemical abnormalities, slight hepatosplenomegaly, or both during much if not all of these quiescent periods. The patients described by Talamo and Feingold would appear to be similar.

The few liver biopsies performed during the asymptomatic stage have shown varying degrees of hepatitic activity,³ with progressive portal cirrhosis. None of our posthepatitic patients with the Pi ZZ phenotype has escaped severe and progressive cirrhosis later in childhood or in early adulthood. The quiescent period would appear . . . [Full Text PDF of this Article]

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