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...

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Autores principales:	Urszula Daniluk, Kamila Kwiatek-Sredzinska, Piotr Jakimiec, Jaroslaw Daniluk, Aleksandra Czajkowska, Dariusz Marek Lebensztejn
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	inflammatory bowel disease Crohn’s disease ulcerative colitis hepatobiliary manifestations children Medicine R
Acceso en línea:	https://doaj.org/article/4fbea52227224d008804ddbd9ec2e16b
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spelling	oai:doaj.org-article:4fbea52227224d008804ddbd9ec2e16b2021-11-25T18:02:06ZLiver Pathology in Children with Diagnosed Inflammatory Bowel Disease—A Single Center Experience10.3390/jcm102253592077-0383https://doaj.org/article/4fbea52227224d008804ddbd9ec2e16b2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5359https://doaj.org/toc/2077-0383Background: 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.Urszula DanilukKamila Kwiatek-SredzinskaPiotr JakimiecJaroslaw DanilukAleksandra CzajkowskaDariusz Marek LebensztejnMDPI AGarticleinflammatory bowel diseaseCrohn’s diseaseulcerative colitishepatobiliary manifestationschildrenMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5359, p 5359 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	inflammatory bowel disease Crohn’s disease ulcerative colitis hepatobiliary manifestations children Medicine R
spellingShingle	inflammatory bowel disease Crohn’s disease ulcerative colitis hepatobiliary manifestations children Medicine R Urszula Daniluk Kamila Kwiatek-Sredzinska Piotr Jakimiec Jaroslaw Daniluk Aleksandra Czajkowska Dariusz Marek Lebensztejn Liver Pathology in Children with Diagnosed Inflammatory Bowel Disease—A Single Center Experience
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	article
author	Urszula Daniluk Kamila Kwiatek-Sredzinska Piotr Jakimiec Jaroslaw Daniluk Aleksandra Czajkowska Dariusz Marek Lebensztejn
author_facet	Urszula Daniluk Kamila Kwiatek-Sredzinska Piotr Jakimiec Jaroslaw Daniluk Aleksandra Czajkowska Dariusz Marek Lebensztejn
author_sort	Urszula Daniluk
title	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_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_sort	liver pathology in children with diagnosed inflammatory bowel disease—a single center experience
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/4fbea52227224d008804ddbd9ec2e16b
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Liver Pathology in Children with Diagnosed Inflammatory Bowel Disease—A Single Center Experience

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