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Liver Pathology in Children with Diagnosed Inflammatory Bowel Disease—A Single Center Experience
Background: Inflammatory bowel disease (IBD) in children is frequently associated with liver pathology manifested as transient elevation of liver enzymes or specified liver diseases. The aim of the study was to evaluate the prevalence and the type of liver pathology in children with IBD within 2 yea...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8621401/ https://www.ncbi.nlm.nih.gov/pubmed/34830641 http://dx.doi.org/10.3390/jcm10225359 |
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author | Daniluk, Urszula Kwiatek-Sredzinska, Kamila Jakimiec, Piotr Daniluk, Jaroslaw Czajkowska, Aleksandra Lebensztejn, Dariusz Marek |
author_facet | Daniluk, Urszula Kwiatek-Sredzinska, Kamila Jakimiec, Piotr Daniluk, Jaroslaw Czajkowska, Aleksandra Lebensztejn, Dariusz Marek |
author_sort | Daniluk, Urszula |
collection | PubMed |
description | Background: Inflammatory bowel disease (IBD) in children is frequently associated with liver pathology manifested as transient elevation of liver enzymes or specified liver diseases. The aim of the study was to evaluate the prevalence and the type of liver pathology in children with IBD within 2 years’ follow-up after the IBD diagnosis. Methods: We retrospectively reviewed records of children with IBD. Liver pathology was defined as elevated activity of liver enzymes (alanine transaminase (ALT) and/or gamma-glutamyl transpeptidase (GGT)) and bilirubin concentration in serum and/or as pathological changes of the organ on imaging tests (abdominal ultrasound and/or magnetic resonance cholangiopancreatography) or on liver histology performed when indicated. Results: Liver pathology was detected in 21 from 119 children (18%), including 7 (17%) with Crohn’s disease (CD) and 14 (18%) with ulcerative colitis (UC). Specified diagnosis for liver abnormality was found in 14 of 21 children (67%), including primary sclerosing cholangitis (PSC, 19%), non-alcoholic fatty liver disease (NAFLD, 19%), autoimmune sclerosing cholangitis (ASC, 5%), autoimmune hepatitis (AIH, 5%), cholelithiasis (5%), drug-induced liver disease (9%) and viral infection (herpes simplex virus, 5%). Most patients manifested mild IBD or were in clinical remission at the time of liver pathology diagnosis. 14% of patients with liver disease (including only cases with PSC) were diagnosed before IBD, 33% at the same time, and 52% in the later period. Patients with the specified diagnosis of liver pathology were younger, had higher ALT activity and more often demonstrated liver abnormalities on imaging tests. UC patients with idiopathic elevation of liver enzymes had higher pediatric ulcerative colitis activity index scores compared to children with specified liver disease. Conclusions: Liver pathology was observed in a significant percentage of children with IBD in our study. The majority of cases of hepatobiliary abnormalities were detected after diagnosis of IBD; therefore, children with IBD should undergo routine monitoring of liver enzymes. |
format | Online Article Text |
id | pubmed-8621401 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-86214012021-11-27 Liver Pathology in Children with Diagnosed Inflammatory Bowel Disease—A Single Center Experience Daniluk, Urszula Kwiatek-Sredzinska, Kamila Jakimiec, Piotr Daniluk, Jaroslaw Czajkowska, Aleksandra Lebensztejn, Dariusz Marek J Clin Med Article Background: Inflammatory bowel disease (IBD) in children is frequently associated with liver pathology manifested as transient elevation of liver enzymes or specified liver diseases. The aim of the study was to evaluate the prevalence and the type of liver pathology in children with IBD within 2 years’ follow-up after the IBD diagnosis. Methods: We retrospectively reviewed records of children with IBD. Liver pathology was defined as elevated activity of liver enzymes (alanine transaminase (ALT) and/or gamma-glutamyl transpeptidase (GGT)) and bilirubin concentration in serum and/or as pathological changes of the organ on imaging tests (abdominal ultrasound and/or magnetic resonance cholangiopancreatography) or on liver histology performed when indicated. Results: Liver pathology was detected in 21 from 119 children (18%), including 7 (17%) with Crohn’s disease (CD) and 14 (18%) with ulcerative colitis (UC). Specified diagnosis for liver abnormality was found in 14 of 21 children (67%), including primary sclerosing cholangitis (PSC, 19%), non-alcoholic fatty liver disease (NAFLD, 19%), autoimmune sclerosing cholangitis (ASC, 5%), autoimmune hepatitis (AIH, 5%), cholelithiasis (5%), drug-induced liver disease (9%) and viral infection (herpes simplex virus, 5%). Most patients manifested mild IBD or were in clinical remission at the time of liver pathology diagnosis. 14% of patients with liver disease (including only cases with PSC) were diagnosed before IBD, 33% at the same time, and 52% in the later period. Patients with the specified diagnosis of liver pathology were younger, had higher ALT activity and more often demonstrated liver abnormalities on imaging tests. UC patients with idiopathic elevation of liver enzymes had higher pediatric ulcerative colitis activity index scores compared to children with specified liver disease. Conclusions: Liver pathology was observed in a significant percentage of children with IBD in our study. The majority of cases of hepatobiliary abnormalities were detected after diagnosis of IBD; therefore, children with IBD should undergo routine monitoring of liver enzymes. MDPI 2021-11-17 /pmc/articles/PMC8621401/ /pubmed/34830641 http://dx.doi.org/10.3390/jcm10225359 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Daniluk, Urszula Kwiatek-Sredzinska, Kamila Jakimiec, Piotr Daniluk, Jaroslaw Czajkowska, Aleksandra Lebensztejn, Dariusz Marek Liver Pathology in Children with Diagnosed Inflammatory Bowel Disease—A Single Center Experience |
title | Liver Pathology in Children with Diagnosed Inflammatory Bowel Disease—A Single Center Experience |
title_full | Liver Pathology in Children with Diagnosed Inflammatory Bowel Disease—A Single Center Experience |
title_fullStr | Liver Pathology in Children with Diagnosed Inflammatory Bowel Disease—A Single Center Experience |
title_full_unstemmed | Liver Pathology in Children with Diagnosed Inflammatory Bowel Disease—A Single Center Experience |
title_short | Liver Pathology in Children with Diagnosed Inflammatory Bowel Disease—A Single Center Experience |
title_sort | liver pathology in children with diagnosed inflammatory bowel disease—a single center experience |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8621401/ https://www.ncbi.nlm.nih.gov/pubmed/34830641 http://dx.doi.org/10.3390/jcm10225359 |
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