Phenotypic spectrum and diagnostic pitfalls of ABCB4 deficiency depending on age of onset

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I whakaputaina i:Hepatology Communications vol. 2, no. 5 (May 2018), p. 504
Kaituhi matua: Schatz, Stephanie Barbara
Ētahi atu kaituhi: Jüngst, Christoph, Verena Keitel‐Anselmo, Kubitz, Ralf, Becker, Christina, Gerner, Patrick, Eva‐Doreen Pfister, Goldschmidt, Imeke, Junge, Norman, Wenning, Daniel, Gehring, Stephan, Arens, Stefan, Bretschneider, Dirk, Grothues, Dirk, Engelmann, Guido, Lammert, Frank, Baumann, Ulrich
I whakaputaina:
Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
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Urunga tuihono:Citation/Abstract
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LEADER 00000nab a2200000uu 4500
001 2329723504
003 UK-CbPIL
022 |a 2471-254X 
024 7 |a 10.1002/hep4.1149  |2 doi 
035 |a 2329723504 
045 2 |b d20180501  |b d20180531 
100 1 |a Schatz, Stephanie Barbara  |u Hannover Medical School, Division of Pediatric Gastroenterology and Hepatology, Department of Pediatric Kidney, Liver, and Metabolic Diseases, Hannover, Germany 
245 1 |a Phenotypic spectrum and diagnostic pitfalls of ABCB4 deficiency depending on age of onset 
260 |b Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins  |c May 2018 
513 |a Journal Article 
520 3 |a Genetic variants in the adenosine triphosphate‐binding cassette subfamily B member 4 (ABCB4) gene, which encodes hepatocanalicular phosphatidylcholine floppase, can lead to different phenotypes, such as progressive familial intrahepatic cholestasis (PFIC) type 3, low phospholipid‐associated cholelithiasis, and intrahepatic cholestasis of pregnancy. The aim of this multicenter project was to collect information on onset and progression of this entity in different age groups and to assess the relevance of this disease for the differential diagnosis of chronic liver disease. Clinical and laboratory data of 38 patients (17 males, 21 females, from 29 families) with homozygous or (compound) heterozygous ABCB4 mutations were retrospectively collected. For further analysis, patients were grouped according to the age at clinical diagnosis of ABCB4‐associated liver disease into younger age (<18 years) or adult age (≥18 years). All 26 patients diagnosed in childhood presented with pruritus (median age 1 year). Hepatomegaly and splenomegaly were present in 85% and 96% of these patients, respectively, followed by jaundice (62%) and portal hypertension (69%). Initial symptoms preceded diagnosis by 1 year, and 13 patients received a liver transplant (median age 6.9 years). Of note, 9 patients were misdiagnosed as biliary atresia, Alagille syndrome, or PFIC type 1. In the 12 patients with diagnosis in adulthood, the clinical phenotype was generally less severe, including intrahepatic cholestasis of pregnancy, low phospholipid‐associated cholelithiasis, or (non)cirrhotic PFIC3. Conclusion: ABCB4 deficiency with onset in younger patients caused a more severe PFIC type 3 phenotype with the need for liver transplantation in half the children. Patients with milder phenotypes are often not diagnosed before adulthood. One third of the children with PFIC type 3 were initially misdiagnosed, indicating the need for better diagnostic tools and medical education. (Hepatology Communications 2018;2:504‐514) 
653 |a Laboratories 
653 |a Patients 
653 |a Acids 
653 |a Transplants & implants 
653 |a Bile 
653 |a Age 
653 |a Mutation 
653 |a Hypertension 
653 |a Adenosine triphosphate 
653 |a Gallbladder diseases 
653 |a Data collection 
653 |a Gallstones 
653 |a Liver cirrhosis 
653 |a Genotype & phenotype 
653 |a Liver diseases 
653 |a Pruritus 
700 1 |a Jüngst, Christoph  |u Department of Medicine II, Saarland University Medical Center, Homburg, Germany 
700 1 |a Verena Keitel‐Anselmo  |u University Hospital, Heinrich Heine University Düsseldorf, Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf, Germany 
700 1 |a Kubitz, Ralf  |u University Hospital, Heinrich Heine University Düsseldorf, Department of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf, Germany 
700 1 |a Becker, Christina  |u Department of Medicine II, Saarland University Medical Center, Homburg, Germany 
700 1 |a Gerner, Patrick  |u Division of Pediatric Gastroenterology, Clinic for Pediatrics II, University Hospital, University Essen, Essen, Germany 
700 1 |a Eva‐Doreen Pfister  |u Hannover Medical School, Division of Pediatric Gastroenterology and Hepatology, Department of Pediatric Kidney, Liver, and Metabolic Diseases, Hannover, Germany 
700 1 |a Goldschmidt, Imeke  |u Hannover Medical School, Division of Pediatric Gastroenterology and Hepatology, Department of Pediatric Kidney, Liver, and Metabolic Diseases, Hannover, Germany 
700 1 |a Junge, Norman  |u Hannover Medical School, Division of Pediatric Gastroenterology and Hepatology, Department of Pediatric Kidney, Liver, and Metabolic Diseases, Hannover, Germany 
700 1 |a Wenning, Daniel  |u Department of General Pediatrics, University Hospital, Heidelberg, Germany 
700 1 |a Gehring, Stephan  |u Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany 
700 1 |a Arens, Stefan  |u Klinikum Kassel, Pediatric Gastroenterology, Kassel, Germany 
700 1 |a Bretschneider, Dirk  |u Klinik St. Marienstift, Magdeburg, Germany 
700 1 |a Grothues, Dirk  |u KUNO University Children's Hospital, Regensburg, Germany 
700 1 |a Engelmann, Guido  |u Lukaskrankenhaus, Children's Hospital, Neuss, Germany 
700 1 |a Lammert, Frank  |u Department of Medicine II, Saarland University Medical Center, Homburg, Germany 
700 1 |a Baumann, Ulrich  |u Hannover Medical School, Division of Pediatric Gastroenterology and Hepatology, Department of Pediatric Kidney, Liver, and Metabolic Diseases, Hannover, Germany; Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom 
773 0 |t Hepatology Communications  |g vol. 2, no. 5 (May 2018), p. 504 
786 0 |d ProQuest  |t Health & Medical Collection 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/2329723504/abstract/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text  |u https://www.proquest.com/docview/2329723504/fulltext/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/2329723504/fulltextPDF/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch