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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
Summary
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.
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