Hepatobiliary alterations in inflammatory bowel disease in pediatrics
Keywords:
Hepatobiliary disorders, pediatric inflammatory bowel disease (IBD), ulcerative rectocolitis (UCR), Crohn's disease (CD), indeterminate colitis (IC), extraintestinal manifestations (MEI), Primary sclerosing cholangitis (PSC)Abstract
Background: Inflammatory bowel disease includes Crohn's disease, ulcerative rectocolitis and indeterminate colitis, whose evolution is chronic and fluctuating, and present various extraintestinal manifestations, mainly in the hepatobiliary tree Objective: To describe the hepatobiliary alterations of inflammatory bowel disease in patients pediatric patients of the Gastroenterology clinic of the JM De Los Ríos Hospital, during the period 2002-2023. Patients and Methods: Descriptive, observational, ambispective, cross-sectional study; patients diagnosed with inflammatory bowel disease between the ages of 2 and 18 years are included; who met inclusion criteria for IBD; Obtaining the information through medical records. The data was analyzed by descriptive statistics; mean, median and percentages Results: 33 patients diagnosed with IBD: RCU 22/33 (67%), CD 10/33 (30%) and CI 1/33 (3%). The average age of debut was 10 years. We found extra intestinal manifestations in 30/33 (91%); Hepatobiliary alterations being the most frequent 15/33 (45%), predominantly transient hypertransaminasaemia 12/15 (80%), followed by primary sclerosing cholangitis (PSC), 2/15 (13%) and gallbladder lithiasis 1/15 (7 %). The ultrasound findings were; diffuse liver parenchymal process 9/15 (60%), hepatomegaly 3/15 (20%), ascites 1/15 (7%), periportal fibrosis 1/15 (7%), and gallstones 1/15 (7%) . 47% of the patients had a severe IBD clinical activity index at the time of the hepatobiliary alterations. Conclusion: Extraintestinal complications in IBD are common; including liver and biliary tree involvement. Clinical and paraclinical evaluation is important in order to obtain a timely diagnosis and establish an early treatment that avoids other complications and manages to optimize the quality of life of patients in this age group.
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Yamamoto-Furusho JK, Bosques-Padilla F, de-Paula J, Galiano MT, Ibañez P, Juliao F, Kotze PG, Rocha JL, Steinwurz F, Veitia G, Zaltman C. Diagnosis and treatment of inflammatory bowel disease: First Latin American Consensus of the Pan American Crohn's and Colitis Organisation. Rev Gastroenterol Mex. 2017 Jan-Mar;82(1):46-84. English, Spanish. doi: 10.1016/j.rgmx.2016.07.003. Epub 2016 Dec 13. PMID: 27979414.
Hepatología y Nutrición Pediátrica Tratamiento en Gastroenterología, Hepatología y Nutrición Pediátrica. 5a edición. Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica, 2021.
Society for Paediatric Gastroenterology Hepatology and Nutrition and European Society of Gastrointestinal Endoscopy Guidelines. Journal of Pediatric Gastroenterology and Nutrition: January 2017 - Volume 64 - Issue 1 - p 133-153 doi: 10.1097/MPG.0000000000001408
Asociación Española de Pediatría. Protocolos actualizados al año 2022. Consulte condiciones de uso y posibles nuevas actualizaciones en www.aeped.es/protocolos/ ISSN 2171-8172.
Órgano de expresión de la Sociedad Española de Pediatría Extrahospitalaria y Atención Primaria (SEPEAP) https://www.pediatriaintegral.es/wp-content/uploads/2015/xix02/05/n2-119-126_Maria%20Mtnez.pdf.
Cerrillo E, González ES, Bastida G, Nos P. Manifestaciones extraintestinales en la enfermedad inflamatoria intestinal. Medicine - Programa de Formación Médica Continuada Acreditado. 2020;13(11):618–30
Solís Herruzo J. A., Solís-Muñoz P. Manifestaciones hepatobiliares en la enfermedad inflamatoria intestinal. Rev. esp. enferm. dig. [Internet]. 2007; 99(9):525-542. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082007000900008&lng=es
Fousekis FS, Theopistos VI, Katsanos KH, Tsianos EV, Christodoulou DK. Hepatobiliary Manifestations and Complications in Inflammatory Bowel Disease: A Review. Gastroenterology Res. 2018;11(2):83-94. doi: 10.14740/gr990w. Epub 2018 Apr 7. PMID: 29707074; PMCID: PMC5916631.
Cappello M, Randazzo C, Bravatà I, Licata A, Peralta S, Craxì A, Almasio PL. Liver Function Test Abnormalities in Patients with Inflammatory Bowel Diseases: A Hospital-based Survey. Clin Med Insights Gastroenterol. 2014 17; 7:25-31. doi: 10.4137/CGast.S13125. PMID: 24966712; PMCID: PMC4069044
Paredes-Méndez Juan, Otoya-Moreno Guillermo, Mestanza-Rivas-Plata Ana Lucía, Lazo-Molina Luis, Acuña-Ordoñez Katia, Arenas-Gamio José Luis et al. Características epidemiológicas y clínicas de la enfermedad inflamatoria intestinal en un hospital de referencia de Lima-Perú. Rev. gastroenterol. Perú [Internet]. 2016.
Fragoso Arbelo Trini, García Bacallao Elsa, García Pérez Wladimiro, Trujillo Toledo, María Elena, Rodríguez Ramírez Emilio, García Soto Eduviges et al. Estudio epidemiológico de la enfermedad inflamatoria intestinal en niños y adolescentes cubanos (estudio multicéntrico). Rev Cubana Pediatr [Internet]. 2002
Larrosa-Haro A, et al. Tendencia epidemiológica de la enfermedad intestinal inflamatoria en pacientes pediátricos en América Latina: Grupo de Trabajo en Enfermedad Intestinal Inflamatoria, Sociedad Latinoamericana. Revista de Gastroenterología de México. 2020. https://doi.org/10.1016/j.rgmx.2020.07.010
Rogler G, Singh A, Kavanaugh A, Rubin DT. Extraintestinal Manifestations of Inflammatory Bowel Disease: Current Concepts, Treatment, and Implications for Disease Management. Gastroenterology. 2021 Oct;161(4):1118-1132. doi: 10.1053/j.gastro.2021.07.042. Epub 2021 Aug 3. PMID: 34358489; PMCID: PMC8564770.
Grossman BJ, De Benedetti CD. Manifestaciones extraintestinales de la enfermedad inflamatoria intestinal crónica en niños. Proc Inst Med Chic 1970;
Stawarski A, Iwanczak B, Krzesiek E, et al. [Intestinal complications and extraintestinal manifestations in children with inflammatory bowel disease]. Pol Merkur Lekarski 2006; 20:22–5
Repiso A., Alcántara M., Muñoz-Rosas C., Rodríguez-Merlo R., Pérez-Grueso M. J., Carrobles J. M. et al. Manifestaciones extraintestinales de la enfermedad de Crohn: Prevalencia y factores relacionados. Rev. esp. enferm. dig. [Internet]. 2006.
Ott, C., Schölmerich, J. Extraintestinal manifestations and complications in IBD. Nat Rev Gastroenterol Hepatol 2013; 10, 585–595. https://doi.org/10.1038/nrgastro.2013.117.
Fousekis FS, Theopistos VI, Katsanos KH, Tsianos EV, Christodoulou DK. Hepatobiliary Manifestations and Complications in Inflammatory Bowel Disease: A Review. Gastroenterology Res. 2018;11(2):83-94. doi: 10.14740/gr990w. Epub 2018 Apr 7. PMID: 29707074; PMCID: PMC5916631.
Hano García Olga Marina, Ojeda Abizaid Yirian Tatiana, González Fabián Licet, Sánchez Rodríguez Yoan Antonio. Manifestaciones hepatobiliares en pacientes con enfermedad inflamatoria crónica intestinal. Rev Cubana Invest Bioméd [Internet]. 2012.
Solís Herruzo J. A., Solís-Muñoz P. Manifestaciones hepatobiliares en la enfermedad inflamatoria intestinal. Rev. esp. enferm. dig. [Internet]. 2007.
Fousekis FS, Theopistos VI, Katsanos KH, Tsianos EV, Christodoulou DK. Hepatobiliary Manifestations and Complications in Inflammatory Bowel Disease: A Review. Gastroenterology Res. 2018;11(2):83-94. doi: 10.14740/gr990w. Epub 2018 Apr 7. PMID: 29707074; PMCID: PMC5916631.
Mazza S, Soro S, Verga MC, Elvo B, Ferretti F, Cereatti F, Drago A, Grassia R. Liver-side of inflammatory bowel diseases: Hepatobiliary and drug-induced disorders. World J Hepatol. 2021;13(12):1828-1849. doi: 10.4254/wjh.v13.i12.1828. PMID: 35069993; PMCID: PMC8727201.
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