Hepatomegaly syndrome in children is also known as Debre’s syndrome II and Baker-Winegard syndrome. It is characterized by hypotonia associated with accumulation of fat and glycogen in the liver caused by disorder of carbohydrate and lipid metabolism. It has varied etiology. Various approaches are employed for the management of hepatomegaly syndrome, one of which includes herbal therapy.

The investigators of the present study assessed the efficacy and safety of an herbal formulation, comprising of Capparis spinosa, Cichorium intybus, Solanum nigrum, Terminalia arjuna, Cassia occidentalis, Achillea millefolium, Tamarix gallica, in children with hepatomegaly syndrome associated with or without viral infection. A total of 71 children with hepatomegaly syndrome, 2-17 years of age, were enrolled in the trial and were studied over a period of six months. Among these, 51 were administered an herbal formulation, while 20 were included as control group. The protocol included administration of the herbal syrup in following dose: 2.5 ml twice daily for children under 12 years of age and 5 ml twice daily for children above 12 years.

All the children were evaluated at 2, 4 and 6 months. The treatment was discontinued after four months. Effectiveness of therapy was determined as improvement of appetite, well-being, gain in the weight and waist size, relief from nausea, improvement in the liver function tests and reduction in hepatomegaly which was evident by clinical examination as well as ultrasonography.

The main biochemical markers examined were aspartate and alanine transaminase (AST and ALT), lactate dehydrogenase (LDH), gamma-glutamyl transpeptidase, immunoglobulins and serum proteins, especially albumin. 

The results divulged that children who were treated with the herbal syrup showed amelioration in asthenia, suggestive of weight gain. They also showed remarkable improvement in appetite, dynamic daily activities and reduced nausea. Furthermore, reduced liver and spleen size was also observed during the first 4 months of the treatment with the syrup. Significant decrease in AST and ALT values and LDH level was also reported following therapy.

Pediatric population treated with the herbal syrup also had accelerated synthesis of gamma globulins and improved protein synthesis which remained at the normal level even after discontinuation of treatment. GTT was also found to be significantly reduced with the treatment, and the normal level was retained after discontinuation of the drug. 

Thus, based on improvement in clinical signs and biochemical parameters, it is evident that the herbal formulation therapy can be beneficial in the management of hepatomegaly syndrome in children.

Source: Marginean O, Micle I, Lesovici M, Balean R, Ioana. Use of hepatoprotective agents in hepatomegaly syndrome in children: An experience with Liv.52 Syrup. Medicine Update. 2002;8(10):57-60.