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Colitis-associated sclerosing cholangitis in children: a single centre experience

G Noble-Jamieson1, R B Heuschkel, F Torrente

  • 1Department of Paediatric Gastroenterology, Addenbrooke's Hospital, Cambridge University, UK.

Journal of Crohn'S & Colitis
|March 15, 2013
PubMed

Insights

Pediatric inflammatory bowel disease (IBD) patients with abnormal liver tests show a higher prevalence of hepato-biliary disease than previously thought. Early diagnosis via liver biopsy and cholangiography is recommended for better management.

Area of Science:

  • Hepatology
  • Gastroenterology
  • Pediatric IBD

Background:

  • Sclerosing cholangitis (SC) is an immune-mediated manifestation of inflammatory bowel disease (IBD), primarily ulcerative colitis (UC).
  • Reported prevalence of SC in pediatric UC patients is low (2-7%).
  • This study investigates hepatological findings in children with inflammatory colitis and elevated liver function tests (LFTs).

Purpose of the Study:

  • To determine the prevalence of hepato-biliary disease in children with inflammatory colitis and abnormal LFTs.
  • To highlight the importance of early diagnosis and management of IBD-associated hepato-biliary disease in pediatric patients.

Main Methods:

  • Retrospective review of medical records.
  • Study included 17 children and adolescents with inflammatory colitis and abnormal LFTs.
  • Procedures included liver biopsy and cholangiography.

Main Results:

  • 17 out of 52 patients (32.6%) with inflammatory colitis had abnormal LFTs.
  • All 17 patients with abnormal LFTs were diagnosed with hepato-biliary disease.
  • This represents a higher prevalence than previously reported in pediatric IBD.

Conclusions:

  • The prevalence of IBD-associated hepato-biliary disease in children with abnormal LFTs is significantly higher than previously reported.
  • Diagnosis impacts patient management.
  • Recommend liver biopsy and cholangiography for all children with inflammatory colitis and abnormal LFTs.
Abstract

Keywords:
Auto-immune liver diseaseHepato-biliary disease;Inflammatory bowel disease;Sclerosing cholangitis;Ulcerative colitis;

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