Colitis-associated sclerosing cholangitis in children: a single centre experience.
OBJECTIVE
Sclerosing cholangitis (SC) is an important immune-mediated extra-intestinal manifestation of inflammatory bowel disease (IBD), primarily affecting patients with ulcerative colitis (UC). The reported prevalence of SC in adults and children with UC is low at between 2 and 7%. We present findings from a hepatological work-up in children with inflammatory colitis and elevated liver function tests (LFT) from a tertiary paediatric gastroenterology unit.


DESIGN
This study is designed as a retrospective review of the medical records of 17 children and adolescents with inflammatory colitis and abnormal LFTs who presented to our IBD service between April 2004 and April 2012.


RESULTS
Over the eight year period a total of 52 patients were diagnosed with inflammatory colitis (ulcerative colitis and unclassified colitis). Seventeen of the 52 patients had abnormal liver function tests and underwent liver biopsy and cholangiography. All 17 patients (32.6%) were diagnosed with hepato-biliary disease.


CONCLUSION
This is one of the largest reported series of children with inflammatory colitis and associated hepato-biliary disease. The data from this patient group indicate that the prevalence of IBD-associated hepato-biliary disease in children with abnormal LFTs is much higher than previously reported. As the diagnosis of IBD-associated hepato-biliary disease affects patient management, we recommend liver biopsy and cholangiography in all children with inflammatory colitis and abnormal liver function tests.
['Noble-Jamieson|G|G|', 'Heuschkel|R B|RB|', 'Torrente|F|F|', 'Hadzic|N|N|', 'Zilbauer|M|M|']
D000293:Adolescent D000410:Alanine Transaminase D000893:Anti-Inflammatory Agents D001706:Biopsy D002648:Child D002756:Cholagogues and Choleretics D049448:Cholangiopancreatography, Magnetic Resonance D015209:Cholangitis, Sclerosing D003093:Colitis, Ulcerative D005260:Female D006801:Humans D007413:Intestinal Mucosa D008099:Liver D008111:Liver Function Tests D008297:Male D011239:Prednisolone D012189:Retrospective Studies D014580:Ursodeoxycholic Acid D005723:gamma-Glutamyltransferase
Sclerosing cholangitis Inflammatory bowel disease Ulcerative colitis Hepato-biliary disease Auto-immune liver disease